PATIENT COMPLIANCE WITH DEEP VEIN THROMBOSIS PROPHYLAXIS FOLLOWING LOWER LIMB ARTHROPLASTY SURGERY

Abstract

Introduction: We undertook a questionnaire study to assess the compliance with DVT prophylaxis following lower limb arthroplasty surgery and evaluate reasons for non-compliance (if any).

Method: Following joint replacement surgery, 50 patients (45 had THR, 5 had TKR) were asked to fill in anonymised questionnaire at 6 weeks. They were asked about awareness for DVT, information given, prevention methods, duration and type of prophylaxis given and their compliance with treatment.

Results: Most of the patients (45) were aware of the risk of DVT while 2 were not aware and 3 were not sure. 37 patients were given information during their clinic visit while 7 did not receive any information and 6 can’t remember. 32 patients remembered discussing risk of developing DVT while 9 did not and 9 were not sure. 34 patients (68%) were aware of prophylactic methods. Except for 2 patients, the rest 48 patients (96%) confirmed receiving prophylaxis. 48 patients (96%) had mechanical prophylaxis in the ward while 6 continued at home as well. 46 patients (92%)remembered receiving chemical prophylaxis both in the ward and at home thereafter.

36 patients received chemical prophylaxis (injections) for 10 days, 5 for 7 days, 8 for a few days and 1 patient for 6 weeks post-op. 38 patients (76%) self administrated the injections while 6 had family members help and 3 had district nurse visit. 47 patients (94%) received injections for the complete duration. 3 patients did not receive injections regularly at home (missed nurse visit – 1, not advised – 1, forgot to inject – 1).

Discussion: DVT compliance is still an issue in surgery especially when patients were asked to self-administer the injections. We achieved 94 % compliance with our protocol. This study shows that greater emphasis on patient education, awareness and motivation may help improve compliance.