IMPLEMENTATION OF THE NICE GUIDELINES FOR VENOUS THROMBOPROPHYLAXIS: A NATIONAL SURVEY OF HIP SURGEONS

Abstract

The 2007 National Institute for health and Clinical Excellence (NICE) thromboprophylaxis guidelines concerning hip arthroplasty remain contentious. A survey among British Hip Society members was performed to investigate the impact of these guidelines. Information on thromboprophylactic measures before and after guideline publication was gathered in the three categories of Total Hip Replacement (THR), hip fracture and high-risk patients as defined by NICE. The response rate was 185/250 (74%). All responders used thromboprophylaxis, but only 44%, 22% and 7% indicated they were currently acting in accordance with guidance for THR, high risk and hip fracture groups respectively. 19%, 14% and 14% had changed their practice since publication of the guidance in THR, high risk and hip fracture groups respectively. The effects of the NICE guidance in influencing the responders’ thromboprophylactic protocols have been very limited. These results do not appear to endorse the authority of NICE in decisions made in this area.