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Published on: February 10, 2023

Implementation of the NICE guidelines for venous thromboprophylaxis; a national survey of hip surgeons

Khalid M Sharif1, Sheikh Fazal Rehman, Timothy Nunn

  • 1Diana Princess of Wales Hospital, Grimsby, UK. khalidsharif2005@yahoo.co.uk

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|May 21, 2009
PubMed

Insights

The 2007 UK National Institute for Health and Clinical Excellence (NICE) guidelines on hip surgery blood clots have had limited impact. Most surgeons do not fully follow these thromboprophylaxis recommendations.

Area of Science:

  • Orthopedic Surgery
  • Public Health Policy
  • Pharmacology

Background:

  • The 2007 National Institute for Health and Clinical Excellence (NICE) guidelines for thromboprophylaxis in hip arthroplasty aimed to standardize practice.
  • Despite evidence, these guidelines have faced ongoing debate and questions regarding their clinical adoption.

Purpose of the Study:

  • To assess the impact of the 2007 NICE thromboprophylaxis guidelines on the practices of British Hip Society members.
  • To determine the extent of adherence to NICE guidelines for different patient groups undergoing hip surgery.

Main Methods:

  • A survey was distributed to members of the British Hip Society.
  • Data collected included thromboprophylactic measures used before and after guideline publication for Total Hip Replacement (THR), hip fracture, and high-risk patients.
  • Response rate was 74% (185/250).

Main Results:

  • All surveyed surgeons used thromboprophylaxis.
  • Adherence to NICE guidelines was low: 44% for THR, 22% for high-risk patients, and 7% for hip fracture.
  • Only a small percentage (19%, 14%, 14% respectively) reported changing practice post-guideline publication.

Conclusions:

  • National guidance on thromboprophylaxis in hip surgery has had a limited effect on clinical practice.
  • Further investigation is needed to understand the reasons behind the low adherence to NICE guidelines.

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