Attitudes to prescribing compression stockings for patients with acute dvt: the MASTER registry

Arpaia, Guido; Carpenedo, Monica; Pistelli, Riccardo; Mastrogiacomo, Ornella; Cimminiello, Claudio; Agnelli, Giancarlo

doi:10.1007/s11239-009-0316-4

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…While age did not influence the duration of anticoagulant therapy in one study [16], older patients were more likely to have continuation of parenteral anticoagulation until INR was ≥2 for 24 hours in another study [6]. In an Italian registry, compression stockings were 1.6 times more likely to be prescribed in patients aged 40–60 years than in patients aged >80 years [31].…”

Section: Discussionmentioning

confidence: 89%

The Adherence to Initial Processes of Care in Elderly Patients with Acute Venous Thromboembolism

et al. 2014

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BackgroundWe aimed to assess whether elderly patients with acute venous thromboembolism (VTE) receive recommended initial processes of care and to identify predictors of process adherence.MethodsWe prospectively studied in- and outpatients aged ≥65 years with acute symptomatic VTE in a multicenter cohort study from nine Swiss university- and non-university hospitals between September 2009 and March 2011.We systematically assessed whether initial processes of care, which are recommended by the 2008 American College of Chest Physicians guidelines, were performed in each patient. We used multivariable logistic models to identify patient factors independently associated with process adherence.ResultsOur cohort comprised 950 patients (mean age 76 years). Of these, 86% (645/750) received parenteral anticoagulation for ≥5 days, 54% (405/750) had oral anticoagulation started on the first treatment day, and 37% (274/750) had an international normalized ratio (INR) ≥2 for ≥24 hours before parenteral anticoagulation was discontinued. Overall, 35% (53/153) of patients with cancer received low-molecular-weight heparin monotherapy and 72% (304/423) of patients with symptomatic deep vein thrombosis were prescribed compression stockings. In multivariate analyses, symptomatic pulmonary embolism, hospital-acquired VTE, and concomitant antiplatelet therapy were associated with a significantly lower anticoagulation-related process adherence.ConclusionsAdherence to several recommended processes of care was suboptimal in elderly patients with VTE. Quality of care interventions should particularly focus on processes with low adherence, such as the prescription of continued low-molecular-weight heparin therapy in patients with cancer and the achievement of an INR ≥2 for ≥24 hours before parenteral anticoagulants are stopped.

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Section: Discussionmentioning

confidence: 89%

The Adherence to Initial Processes of Care in Elderly Patients with Acute Venous Thromboembolism

et al. 2014

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“…However, at least in Europe, compression is started already in the acute phase of DVT in the majority of cases as an adjuvant treatment modality to reduce pain and swelling as demonstrated in reviews from France and Italy. 7,8…”

Section: Compression and Walking Reduce Pain And Swelling More Than Bed Restmentioning

confidence: 99%

“…A survey performed in Canada revealed that only 26% of the physicians prescribed compression in the acute phase of DVT 20 which is quite different from the European tradition starting with compression in the vast majority of cases. 7,8 A delayed start with compression could also be one of the reasons for the negative outcome of the recent trial published by Kahn et al 20…”

Section: Logistic Problemsmentioning

confidence: 99%

The Role of Leg Compression in the Treatment of Deep Vein Thrombosis

Partsch

2014

Phlebology

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Up until today mobile outpatients are put into bed as soon as the diagnosis of deep vein thrombosis (DVT) is made. Fear of pulmonary embolism (PE) is the main rationale for bed-rest; additional arguments are pain and swelling which are expected to resolve faster during leg elevation. Based on previous work it is demonstrated that keeping mobile patients with acute DVT walking under exact anticoagulation does not increase the risk for symptomatic PE in comparison with bed-rest and that there is an immediate reduction of pain and swelling when good compression is applied and the patient is encouraged to walk. Immediate compression and walking seems also to reduce the incidence of a postthrombotic syndrome. One presumed mechanism of action of this adjunct treatment modality is the increase of shear stress in the microcirculation of the vein wall releasing anti-inflammatory and anti-coagulatory mediators.

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Knee length versus thigh length graduated compression stockings for prevention of deep vein thrombosis in postoperative surgical patients

Sajid

Desai

Morris

et al. 2012

Cochrane Database of Systematic Reviews

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This review found that there is insufficient high quality evidence to determine whether or not KL and TL GCS differ in their effectiveness in terms of reducing the incidence of deep vein thrombosis (DVT) in hospitalised patients. A major multicentre RCT is required to address this issue. In the meantime, the decision on which type of stocking to use in clinical practice is likely to be influenced by factors such as patient compliance, ease of use and cost implications.

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Attitudes to prescribing compression stockings for patients with acute dvt: the MASTER registry

Abstract: Italian clinicians' attitudes to prescribing ES still appear suboptimal. Special attention is needed for patients treated at home, where organizational problems can interfere with the use of ES.

Cited by 8 publications

References 15 publications

The Adherence to Initial Processes of Care in Elderly Patients with Acute Venous Thromboembolism

The Adherence to Initial Processes of Care in Elderly Patients with Acute Venous Thromboembolism

The Role of Leg Compression in the Treatment of Deep Vein Thrombosis

Knee length versus thigh length graduated compression stockings for prevention of deep vein thrombosis in postoperative surgical patients

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