Patient compliance with outpatient prophylaxis: an observational study

The need for prophylaxis against venous thromboembolic disease following lower-extremity joint replacement is well documented and accepted. Although low molecular weight heparin is approved for inpatient and extended prophylaxis beyond the hospital environment, orthopedic surgeons must determine the duration of injectable low molecular weight heparin based on the period of venous thromboembolic disease risk and on patient compliance with self-administration of medication at home. Lack of confidence in patients' ability to self-administer injections may contribute to hesitancy in prescribing injectable prophylaxis. This observational study evaluated the effectiveness of a self-injection education program. Findings demonstrate that when properly instructed, patients safely and efficaciously self-administer low molecular weight heparin at home. With shorter hospital stays, self-administration of low molecular weight heparin may optimize the clinical outcomes of orthopedic patients.