nach oben

Clinical Orthopaedics and Related Research®

Erschienen in:

01.09.2010 | Clinical Research

Nonadherence in Outpatient Thrombosis Prophylaxis with Low Molecular Weight Heparins after Major Orthopaedic Surgery

verfasst von: Thomas Wilke, PhD, Jörn Moock, PhD, Sabrina Müller, BSc, Matthias Pfannkuche, PhD, Andreas Kurth, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 9/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

According to some current guidelines, extended thromboprophylaxis after hip and knee arthroplasties is recommended. Outpatient prophylaxis with low molecular weight heparins (LMWH) is an important part of this prophylaxis, although the rates of adherence to these regimens is not known.

Questions/purposes

We determined (1) the degree of nonadherence (NA) of patients with LMWH outpatient prophylaxis, and (2) whether specific independent factors explain NA.

Methods

NA was determined by syringe count and by indirect and direct questions to patients. We defined six different NA indicators. To identify factors explaining LMWH NA, we used three different logistic regression models.

Results

NA rates ranged between 13% and 21% depending on the indicator used for measurement. Patients who were nonadherent missed between 38% and 53% of their outpatient LMWH injections. If patients attended an outpatient rehabilitation program, the probability for their NA increased substantially. Moreover, the NA probability increased with each additional day between acute hospitalization and start of rehabilitation (linking days). NA was lower for patients who feared thrombosis or who believed antithrombotic drugs to be the most important measure in thromboprophylaxis.

Level of Evidence

Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Nur mit Berechtigung zugänglich

Andrade SE, Kahler KH, Frech F, Chan KA. Methods for evaluation of medication adherence and persistence using automated databases. Pharmacoepidemiol Drug Saf. 2006;15:565–574; discussion 575–577.CrossRefPubMed

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. Prophylaxe der venösen Thromboembolie (VTE). Available at: http://www.uni-duesseldorf.de/awmf/ll/003-001.htm. Accessed March 24, 2009.

Bjørnarå BT, Gudmundsen TE, Dahl OE. Frequency and timing of clinical venous thromboembolism after major joint surgery. J Bone Joint Surg Br. 2006;88:386–391.CrossRefPubMed

Böttner F, Sculco TP, Sharrock NE, Westrich GH, Steinbeck J. [Prevention of thrombosis in hip prosthesis implantation] [in German]. Orthopäde. 2001;30:890–896.CrossRefPubMed

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631–637.CrossRefPubMed

Bukstein DA, Henk HJ, Luskin AT. A comparison of asthma-related expenditures for patients started on montelukast versus fluticasone propionate as monotherapy. Clin Ther. 2001;23:1589–1600.CrossRefPubMed

Bulkrishnan R, Nelsen LM, Kulkarni AS, Pleasants RA, Whitmire JT, Schechter MS. Outcomes associated with initiation of different controller therapies in a Medicaid asthmatic population: a retrospective data analysis. J Asthma. 2005;41:35–40.CrossRef

Chisholm MA, Lance CE, Williamson GM, Mulloy LL. Development and validation of the immunosuppressant therapy adherence instrument. Nephrol Dial Transplant. 2005;20:181–188.CrossRefPubMed

Colwell CW Jr; Annenberg Center for Health Sciences and Quadrant Medical Education. Thromboprophylaxis in orthopaedic surgery. Am J Orthop. 2006;suppl:1–9; quiz 10–11.

10.

Colwell CW Jr, Pulido P, Hardwick ME, Morris BA. Patient compliance with outpatient prophylaxis: an observational study. Orthopaedics. 2005;28:143–147.

11.

Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed? A novel assessment technique. JAMA. 1989;261:3273–3277.CrossRefPubMed

12.

Donovan JL, Blake DR. Patient non-compliance: deviance or reasoned decision-making. Soc Sci Med. 1992;34:507–513.CrossRefPubMed

13.

Douketis JD, Berger PB, Dunn AS, Jaffer AK, Spyropoulos AC, Becker RC, Ansell J; American College of Chest Physicians. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):299S–339S.CrossRefPubMed

14.

Eikelboom J, Baker R. Routine home treatment of deep vein thrombosis. BMJ. 2001;322:1192–1193.CrossRefPubMed

15.

Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement: a meta-analysis of the randomized trials. Lancet. 2001;358:9–15.CrossRefPubMed

16.

Elliott RA, Shinogle JA, Peele P, Bhosle M, Hughes DA. Understanding medication compliance and persistence from an economics perspective. Value Health. 2008;11:600–610.CrossRefPubMed

17.

Eriksson BI, Borris LC, Friedman RJ, Haas S, Huisman MV, Kakkar AK, Bandel TJ, Beckmann H, Muehlhofer E, Misselwitz F, Geerts W. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. N Engl J Med. 2008;358:2765–2775.CrossRefPubMed

18.

Eriksson BI, Dahl OE, Büller HR, Hettiarachchi R, Rosencher N, Bravo ML, Ahnfelt L, Piovella F, Stangier J, Kälebo P, Reilly P; BISTRO II Study Group. A new oral direct thrombin inhibitor, dabigatran etexilate, compared with enoxaparin for prevention of thromboembolic events following total hip or knee replacement: the BISTRO II randomized trial. J Thromb Haemost. 2005;3:103–111.CrossRefPubMed

19.

Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, Prins MH, Hettiarachchi R, Hantel S, Schnee J, Büller HR; RE-NOVATE Study Group. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial. Lancet. 2007;370:949–956.CrossRefPubMed

20.

Friedman RJ, Gallus AS, Cushner FD, Fitzgerald G, Anderson FA Jr; Global Orthopaedic Registry Investigators. Physician compliance with guidelines for deep-vein thrombosis prevention in total hip and knee arthroplasty. Curr Med Res Opin. 2008;24:87–97.PubMed

21.

Geerts WH, Bergqvist DF, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW; American College of Chest Physicians. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 suppl):381S–453S.CrossRefPubMed

22.

Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 suppl):338S–400S.CrossRefPubMed

23.

Ginsberg JS, Davidson BL, Comp PC, Francis CW, Friedman RJ, Huo MH, Lieberman JR, Muntz JE, Raskob GE, Clements ML, Hantel S, Schnee JM, Caprini JA. Oral thrombin inhibitor dabigatran etexilate vs North American enoxaparin regimen for prevention of venous thromboembolism after knee arthroplasty surgery. J Arthroplasty. 2009;24:1–9.PubMed

24.

Hahn SR, Park J, Skinner EP, Yu-Isenberg KS, Weaver MB, Crawford B, Flowers PW. Development of the ASK-20 adherence barrier survey. Curr Med Res Opin. 2008;24:2127–2138.CrossRefPubMed

25.

Hansen RA, Kim MM, Song L, Tu W, Wu J, Murray MD. Comparison of methods to assess medication adherence and classify nonadherence. Ann Pharmacother. 2009;43:413–422.CrossRefPubMed

26.

Hasford J, Behrend C, Sangha O. Vergleichende Analyse und Bewertung von Methoden zur Erfassung der Compliance. In: Petermann F, ed. Compliance und Selbstmanagement. Göttingen, Germany: Hogrefe; 1998:21–45.

27.

Hawkins D. Pharmacoeconomics of thrombosis management. Pharmacotherapy. 2004;24(7 pt 2):95S–99S.CrossRefPubMed

28.

Haynes RB, McDonald HP, Garg AX. Helping patients follow prescribed treatment: clinical applications. JAMA. 2002;288:2880–2883.CrossRefPubMed

29.

Haynes RB, McDonald HP, Garg AX, Montague P. Interventions for helping patients to follow prescriptions for medications (review). Cochrane Database Syst Rev. 2005;4:CD000011.PubMed

30.

Haynes RB, Taylor DW, Sackett DL, eds. Compliance in Health Care. Baltimore, MD: Johns Hopkins University Press; 1979:49–62.

31.

Haynes RB, Taylor DW, Sackett DL, Gibson ES, Bernholz CD, Mukherjee J. Can simple clinical measurements detect patient noncompliance?. Hypertension. 1980;2:757–764.PubMed

32.

Heuer H, Heuer S, Lennecke K. Compliance in der Arzneitherapie. Stuttgart, Germany: Wissenschaftliche Verlagsgesellschaft; 1999:5–20.

33.

Höntzsch D, Scheffer J, Hafner S, Tolle A, Spannagel U. [Fully automated injection pen for prevention of thrombosis: tolerance, convenience and patient compliance] [in German]. MMW Fortschr Med. 1999;141:50.PubMed

34.

Jerant A, DiMatteo R, Arnsten J, Moore-Hill M, Franks P. Self-report adherence measures in chronic illness: retest reliability and predictive validity. Med Care. 2008;46:1134–1139.CrossRefPubMed

35.

Karliński M, Stolarczyk A, Siuda M, Ziólkowski M. Compliance with low molecular weight heparin in ambulatory orthopaedic patients. Ortop Traumatol Rehabil. 2006;8:633–638.PubMed

36.

Krueger KP, Berger BA, Felkey B. Medication adherence and persistence: a comprehensive review. Adv Ther. 2005;22:313–356.CrossRefPubMed

37.

Lassen MR, Ageno W, Borris LC, Lieberman JR, Rosencher N, Bandel TJ, Misselwitz F, Turpie AG. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008;358:2776–2786.CrossRefPubMed

38.

Le Gall C, Jacques E, Medjebeur C, Darques L, Briand F, Haddad J, Bleichner G. Low molecular weight heparin self-injection training: assessment of feasibility, tolerance and economic analysis in emergency departments. Eur J Emerg Med. 2006;13:264–269.CrossRefPubMed

39.

Lipp HP, Goldinger A, Haussmann W, Krämer I, Pfaff A, Schweitzer E. Antithrombotika zur Therapie und Prophylaxe venöser Thromboembolien. Krankenhauspharmazie. 2004;25:195–210.

40.

Liu H, Miller HG, Hays RD, Golin CE, Zhao H, Wenger NS, Kaplan AH. A comprehensive evaluation of survey questions for adherence to antiretroviral medications and exploratory analyses for identifying optimal sets of survey questions. AIDS Patient Care STDs. 2006;20:760–772.CrossRefPubMed

41.

Mazor KM, Baril J, Dugan E, Spencer F, Burgwinkle P, Gurwitz JH. Patient education about anticoagulant medication: is narrative evidence or statistical evidence more effective? Patient Educ Couns. 2007;69:145–157.CrossRefPubMed

42.

McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA. 2002;288:2868–2879.CrossRefPubMed

43.

Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hyperten (Greenwich). 2008;10:348–354.CrossRef

44.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.CrossRefPubMed

45.

Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353:487–497.CrossRefPubMed

46.

Paes AH, Bakker A, Soe-Agnie CJ. Measurement of patient compliance. Pharm World Sci. 1998;20:73–77.CrossRefPubMed

47.

Petrie KJ, Weinman J. Why illness perceptions matter. CME Psychiatry. 2006;6:536–539.

48.

Rolley JX, Davidson PM, Dennison CR, Ong A, Everett B, Salamonson Y. Medication adherence self-reported instruments: implications for practice and research. J Cardiovasc Nurs. 2008;23:497–505.PubMed

49.

Spahn G. Compliance with self administration of heparin injections in outpatients. Eur J Trauma. 2002;2:104–109.CrossRef

50.

Stannard JP, Lopez-Ben RR, Volgas DA, Anderson ER, Busbee M, Karr DK, McGwin GR Jr, Alonso JE. Prophylaxis against deep-vein thrombosis following trauma: a prospective, randomized comparison of mechanical and pharmacological prophylaxis. J Bone Joint Surg Am. 2006;88:261–266.CrossRefPubMed

51.

Statistisches Bundesamt (Federal Bureau of Statistics Germany), Fachserie 12, Reihe 6.4, year 2008.

52.

Van Aken H, Bode C, Darius H, Diehm C, Encke A, Gulba DC, Haas S, Hacke W, Puhl W, Quante M, Riess H, Scharf R, Schellong S, Schrör T, Schulte KL, Tebbe U. Anticoagulation: the present and future. Clin Appl Thromb Hemost. 2001;7:195–204.CrossRefPubMed

53.

Warwick D, Friedman RJ, Agnelli G, Gil-Garay E, Johnson K, FitzGerald G, Turibio FM. Insufficient duration of venous thromboembolism prophylaxis after total hip or knee replacement when compared to the time course of thromboembolic events. J Bone Joint Surg Br. 2007;89:799–807.CrossRefPubMed

54.

Watts AC, Howie CR, Simpson AH. Assessment of a self-administration protocol for extended subcutaneous thromboprophylaxis in lower limb arthroplasty. J Bone Joint Surg Br. 2006;88:107–110.CrossRefPubMed

55.

Wilke T. Patient preferences for an oral anticoagulant after major orthopaedic surgery: results of a German survey. The Patient. 2009;2:39–49.

56.

Wilke T, Neumann K, Klapper U, Messer I, Werner A, Seidel U, Röleke D. [Oral anticoagulation after major hip or knee replacement surgery: a process-driven managerial pharmacoeconomic analysis in German hospitals] [in German]. Orthopäde. 2008;37:448–456.CrossRefPubMed

57.

Winnick S, Lucas DO, Hartman AL, Toll D. How do you improve compliance? Pediatrics. 2005;115:e718–e724.CrossRefPubMed

58.

World Health Organization. Adherence to Long Term Therapies: Evidence for Action. Geneva, Switzerland: WHO; 2003.

59.

Zeller A, Ramseier E, Teagtmeyer A, Battegay E. Patients’ self-reported adherence to Cardiovascular medication using electronic monitors as comparators. Hypertens Res. 2008;31:2037–2043.CrossRefPubMed

Titel: Nonadherence in Outpatient Thrombosis Prophylaxis with Low Molecular Weight Heparins after Major Orthopaedic Surgery
verfasst von: Thomas Wilke, PhD
Jörn Moock, PhD
Sabrina Müller, BSc
Matthias Pfannkuche, PhD
Andreas Kurth, PhD
Publikationsdatum: 01.09.2010
Verlag: Springer-Verlag
Erschienen in: Clinical Orthopaedics and Related Research® / Ausgabe 9/2010
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1306-8

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Background

Questions/purposes

Methods

Results

Level of Evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2010

Can Computer-assisted Surgery Reduce the Effective Dose for Spinal Fusion and Sacroiliac Screw Insertion?

Intercalary Allograft Reconstructions Using a Compressible Intramedullary Nail: A Preliminary Report

2010 Nicolas Andry Award: Multipotent Adult Stem Cells from Adipose Tissue for Musculoskeletal Tissue Engineering

Risk of Complication and Revision Total Hip Arthroplasty Among Medicare Patients with Different Bearing Surfaces

Should Gram Stains Have a Role in Diagnosing Hip Arthroplasty Infections?