Patient Compliance with Deep Vein Thrombosis Prophylaxis after Total Hip and Total Knee Arthroplasty

Abstract

Even though the Centers for Medicare and Medicaid Services is penalizing hospitals for readmissions, and postoperative prophylaxis has demonstrated reduced complications associated with deep vein thrombosis (DVT), few studies have examined patient compliance with (DVT) prophylaxis at home. A survey querying DVT prophylaxis management and adherence was administered to patients who were within the one to three-month postoperative period after a total knee or total hip replacement. A total of 103 patients completed the survey. A considerable number of patients (17.0%) were non-adherent to DVT prophylaxis. Patients had a lower understanding of the side effects of their DVT prophylaxis, with 30% responding that they had a poor to simple understanding. There is a high rate of non-compliance and there is a poor understanding of complications related to venous thromboembolism prophylaxis. As the population undergoing arthroplasties grows, this study demonstrates the importance of investigating the role of medication adherence in the rate of postoperative DVT.

Effectiveness of Deep Venous Thrombosis Prevention in Total Hip Arthroplasty

“…The financial impact of health policies, especially with regard to prevention, of the treatment of installed thromboembolic event and the cost of medications must be considered, as the use of THA has increased in the world population. 18 One must emphasize that the effectiveness of these measures varies according to the patient's profile, surgical technique used, operative time, 16 patient compliance, 19 as well as their clinical evaluation, since the use of ENX causes laboratory alterations in liver function, in DHL, in 53% of the cases, albeit without clinical repercussions. 20 Thus, an effective measure in preventing VTE and reducing hospital time, in addition to reducing other adverse events, is the early The contraindication for the use of pharmacological methods was: active bleeding or active peptic ulcer, use of anticoagulation, heparin allergy or thrombocytopenia, coagulopathy (thrombocytopenia < 100,000/mm³ or NR°> 1.5), uncontrolled systemic arterial hypertension (> 180 × 110 mmHg), persistent renal failure (clearance < 30 ml/min), recent intracranial or ocular surgery < 2weeks, CSF collection in the last 24 hours.…”

“…One must emphasize that the effectiveness of these measures varies according to the patient’s profile, surgical technique used, operative time, ( 16 patient compliance, ( 19 as well as their clinical evaluation, since the use of ENX causes laboratory alterations in liver function, in DHL, in 53% of the cases, albeit without clinical repercussions. 20…”

Princípios Do Pré E Pós-Operatório

“…Essas drogas devem ser mantidas até a completa deambulação do paciente, podendo em casos selecionados ser utilizado drogas orais anticoagulantes (DOAC) como profilaxia extendida. Pacientes de risco muito elevado de trombose e contraindicação a anticoagulação, como são os casos de pacientes em vigência de sangramentos, podem requerer o implante de filtro de veia cava inferior temporário ou permanente 24 .…”

An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020

“…Although patients trust their providers about taking anti-thrombotic medications after arthroplasty, once a day medications, either oral or injectable, have better patient adherence than twice a day medications [ 79 , 80 ]. Even still, adherence to regimens is generally poor, and there is opportunity for strategies to improve patient adherence [ 81 , 82 , 83 ]. Aspirin is a desirable agent from this perspective because it is an oral medication that can be dosed once daily.…”