Compliance with Low Molecular Weight Heparin in abulatory orthopedic patients

Background The prophylaxis of venous thromboembolism with unfractioned heparins (UFH) was introduced in 1970s and initially applied only in high-risk orthopedic surgery patients. While further studies proved its importance also in those with lower risk, it was the development of LMWH, that enabled wide practical application. The primary objective of this study was to provide a complex evaluation of actual compliance with self-administered Low Molecular Weight Heparin in ambulatory orthopedic patients. Assessment of incidence of LMWH side-effects and thromboembolic episodes despite proper prophylaxis were defined as secondary objectives. Material and methods The research was conducted in Brodnowski Hospital, Warsaw and WSzZ Hospital, Kielce. The group consisted of n=120 (58 females, age 17-82) patients. The selection criteria were: having plaster immobilization definitely removed and being prescribed LMWH as a part of the treatment. Participants were given anonymous questionnaires composed of 25 questions. Satisfactory compliance was defined as application of at least 80% of prescribed injections. Results Compliance with LMWH appeared to be satisfactory in 95.8% cases of which 63,6% were fully and 32,2% partially compliant. The most frequent reasons for dose omission were forgetfulness (48.9%), fear of side-effects (20.0%) and side-effects (13.3%). Side effects were observed in 26.7% of drug applying patients and due to this fact 16.4% temporarily stopped injections. Venous thromboembolism was reported in 6.0%. Conclusions Compliance level in great majority proved to be satisfactory, although the necessity of prophylaxis was far from being fully recognized by the patients. It also seemed unaffected by the significant number of side effects. Thromboembolic episodes were sporadically reported.