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Compression stockings to prevent post-thrombotic syndrome: a role for anticoagulation clinics?

Ann K Wittkowsky1, Edith A Nutescu, Emily Beth Devine

  • 1University of Washington School of Pharmacy, Seattle, WA, USA. akwitt@u.washington.edu

Journal of Thrombosis and Thrombolysis
|December 7, 2007
PubMed

Insights

Anticoagulation clinics rarely prescribe compression stockings for deep vein thrombosis (DVT) patients, despite guidelines recommending them for preventing post-thrombotic syndrome (PTS). Increased clinic responsibility could improve stocking use and adherence.

Area of Science:

  • Vascular Medicine
  • Clinical Pharmacy
  • Thrombosis Management

Background:

  • Anticoagulation clinics manage oral anticoagulant therapy for venous thromboembolic disease (VTE).
  • These clinics are well-positioned to manage other long-term VTE aspects, including post-thrombotic syndrome (PTS) prevention.
  • Current guidelines recommend graduated elastic compression stockings for 2 years post-deep vein thrombosis (DVT) to prevent PTS.

Purpose of the Study:

  • To assess the current use of compression stockings in DVT patients managed by anticoagulation clinics.
  • To determine adherence to recommended compression strength and duration.
  • To explore expanding the scope of practice for anticoagulation clinics in VTE long-term management.

Main Methods:

  • A survey was distributed to healthcare providers in anticoagulation clinics.
  • The survey collected data on the prescription of compression stockings for DVT patients.
  • Data included who prescribed the stockings, compression strength, and duration of therapy.

Main Results:

  • A very low rate of compression stocking prescription for DVT patients was observed.
  • Adherence to current guidelines regarding compression strength and duration was limited.
  • Significant gaps exist between guideline recommendations and current clinical practice.

Conclusions:

  • Anticoagulation clinics currently have low rates of prescribing compression stockings for DVT.
  • There is a need to improve adherence to guidelines for compression stocking use in DVT patients.
  • Expanding the scope of anticoagulation clinics to include comprehensive antithrombosis care, including PTS prevention, is recommended.

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