No difference in patient compliance between full-strength versus low-dose aspirin for VTE prophylaxis following total hip and total knee replacement

Hood, Brandon; Springer, Bryan D.; Odum, Susan M.; Curtin, Brian

doi:10.1007/s00590-020-02833-w

Cited by 3 publications

(4 citation statements)

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“…Hood et al, specifically explored patient compliance in patients prescribed one month of either low-dose or regular-dose ASA after TKA and THA (n = 404) 1826 . There was no significant difference in the proportion of patients who completed their course of therapy, nor the proportion who attributed new GI symptoms to the initiation of ASA (7% vs. 10.5%, p > 0.30).…”

Section: - Is There a Difference Between Low Dose And Regular Dose As...mentioning

confidence: 99%

“…Concerning contemporary regimes of oral prophylaxis, Carrothers et al 1285 , reported adherence rates to rivaroxaban of 83%, and Lebel et al 1286 , reported a rate of 98% to dabigatran, both requiring a single oral administration per day. The difference in compliance between full-strength vs. low-dose aspirin (ASA) for VTE prophylaxis following THA and TKA was measured by Hood et al 1287 , in 404 patients. They were able to reject the null hypothesis of decreased patient compliance utilizing full-strength 325 mg ASA twice daily following total joint arthroplasty (TJA) when compared to low-dose 81 mg twice daily.…”

Section: -Are There Differences Between Various Venous Thromboembolis...mentioning

confidence: 99%

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Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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Section: - Is There a Difference Between Low Dose And Regular Dose As...mentioning

confidence: 99%

Section: -Are There Differences Between Various Venous Thromboembolis...mentioning

confidence: 99%

Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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Section: Discussionmentioning

confidence: 94%

“…In addition, since the completion of this study, the dosage of aspirin used in this study has been changed in our practice to 81 mg twice daily. However, the evaluation of compliance with 81 versus 325 mg was found to be no different in a survey of consecutive patients by Hood et al 19 Figure 2 A, Graph comparing the average compliance of aspirin usage and pump usage in the first 14 (pumps) and 42 (aspirin) days postoperatively after total joint arthroplasty. The average pump compliance at 14 days was 51.4% (SD 6 33), and the average aspirin compliance at this same time point was 99.5% (SD 6 4.1) (P , 0.0001).…”

Section: Discussionmentioning

confidence: 97%

Randomized Trial of Postoperative Venous Thromboembolism Prophylactic Compliance: Aspirin and Mobile Compression Pumps

Dietz

Moushmoush

Frye

et al. 2022

J Am Acad Orthop Surg

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Background: Aspirin, as a routine venous thromboembolism (VTE) prophylaxis, is approved along with pneumatic compression pumps by the American College of Chest Physicians. We assessed compliance of aspirin and pump use after total joint arthroplasty.Methods: A randomized trial of aspirin alone or aspirin/mobile compression pumps after total joint arthroplasty was performed. Aspirin and pump compliance, VTE events, and satisfaction with pump use were collected. Compliance was assessed through an internal device monitor and drug log book. Patients were also contacted 90 days postoperatively for reported symptomatic VTEs.Results: Each group had 40 patients and greater than 94% compliance with aspirin use, with no difference between groups (P = 0.55). Overall pump compliance during the first 14 days after hospital discharge was 51% (SD 6 33), which was significantly worse than aspirin compliance at 99% (SD 6 4.1) (P , 0.0001). Only 10 patients were compliant (.20 hr/d) with recommended pump use throughout the entire recommended period. There was no notable association between aspirin compliance and VTE within 90 days. There was no notable association between pump compliance and VTE at 90 days. However, average pump use compliance was 20% in patients with VTE and 54% in patients without VTE within 90 days. With the numbers available in this compliance study, there was no significant difference (P = 0.11).Discussion: Aspirin compliance was notably greater than pump compliance. In this study, we found that pump compliance was not associated with lower VTE risk. In fact, no increased risk was recognized in patients with an average pump usage of .50%. Further study is warranted to define the duration of pump use required for clinical significance. The recommended use of compression pumps should continue to be examined.

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Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis

Mirghaderi,

Pahlevan-Fallahy,

Rahimzadeh

et al. 2024

J Orthop Surg Res

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Background The adverse effects of aspirin are dose-dependent, and there is controversy surrounding the use of low-dose (LD) aspirin to prevent venous thromboembolism (VTE) following total joint arthroplasty (TJA). This meta-analysis sought to compare the efficacy and complication rate of low-dose (162 mg per day) versus high-dose (HD, 650 mg per day) aspirin after TJA surgery. Methods In four main databases, we searched from inception until September 2024 for articles comparing the rate of VTE following TJA(TKA/THA) using only aspirin chemoprophylaxis with different dosages. We meta-analyzed and compared the VTE and complication rates of LD aspirin (162 mg per day) with HD aspirin (650 mg per day) and presented our results as odds ratio (ORs) in forest plot diagrams. Results There were 14 eligible studies, comprising 43,518 patients in the LD group and 62,645 patients in the HD group. DVT (OR: 1.37, CI: 0.93–2.02, P = 0.11) and PE (OR: 1.86, CI: 0.73–4.72, P = 0.19) rates were similar between the groups. However, taking VTE as the total number of cases with DVT or PE, the incidence was significantly higher in the HD group than in the LD group (OR:1.53, CI: 1.17-2.00, P = 0.002). HD also had a significantly higher rate of PJI (OR:2.68 CI:1.5–4.6 P = 0.001), but gastrointestinal bleeding (GIB) was similar between the two groups (OR: 0.97, CI: 0.42–2.22, P = 0.95). Conclusion The findings suggest that LD aspirin may be a viable option for VTE chemoprophylaxis following TJA, potentially offering comparable efficacy with a lower risk of PJI compared to HD aspirin regimens. Level of Evidence : Therapeutic Level II. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-024-05356-w.

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No difference in patient compliance between full-strength versus low-dose aspirin for VTE prophylaxis following total hip and total knee replacement

Cited by 3 publications

References 19 publications

Recommendations from the ICM-VTE: General

Recommendations from the ICM-VTE: General

Randomized Trial of Postoperative Venous Thromboembolism Prophylactic Compliance: Aspirin and Mobile Compression Pumps

Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis

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