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Extended thromboprophylaxis for hip or knee arthroplasty. Does the administration route and dosage regimen affect adherence? A cohort study.
Int Orthop 2020; 44(2):237-243IO

Abstract

PURPOSE

Prevention of thromboembolic disease requires patients' adherence to the extended thromboprophylaxis scheme. Oral anticoagulants are expected to improve adherence as a result of their route of administration; however, this assumption is yet to be confirmed. The purpose of this study was to assess the impact of the route of administration and dosage regimen on the compliance to the prescription.

MATERIALS AND METHODS

This prospective cohort study included hip and knee arthroplasty patients who received pharmacological extended thromboprophylaxis with one daily injection, one daily oral tablet, or two daily oral tablets. A telephonic questionnaire was applied 35 days after the day of the surgery. Patients who omitted one or more doses of medication during the follow-up period were classified as "non-adherent." Differences of adherence rates were assessed.

RESULTS

Five hundred and twenty patients were included: 153 received Apixaban (oral, twice a day), 155 Enoxaparin (injectable, once a day), and 212 Rivaroxaban (oral, once a day). Patients receiving oral once a day medication was more compliant compared with those who received an oral medication twice a day. Non-adherence rates were 3.2 and 9.2%, respectively (p = 0.033). No significant differences (p = 0.360) were found between oral once a day and injectable once a day medication.

CONCLUSIONS

The number of daily doses prescribed was related to adherence to extended chemical prophylaxis, while the route of administration did not seem to have a significant impact. Strategies to promote outpatient compliance must be implemented, especially when regimes including more than one daily dose are prescribed.

Authors+Show Affiliations

Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá D. C., 110111186, Colombia. School of Medicine, Universidad de Los Andes, Bogotá, Colombia.Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá D. C., 110111186, Colombia. School of Medicine, Universidad del Rosario, Bogota, Colombia.Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá D. C., 110111186, Colombia.Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá D. C., 110111186, Colombia. bonillaguillermo@yahoo.com. School of Medicine, Universidad de Los Andes, Bogotá, Colombia. bonillaguillermo@yahoo.com. School of Medicine, Universidad del Rosario, Bogota, Colombia. bonillaguillermo@yahoo.com.Department of Orthopedics and Traumatology, Hospital Universitario Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá D. C., 110111186, Colombia. School of Medicine, Universidad de Los Andes, Bogotá, Colombia. School of Medicine, Universidad del Rosario, Bogota, Colombia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31807853

Citation

Moreno, Juan P., et al. "Extended Thromboprophylaxis for Hip or Knee Arthroplasty. Does the Administration Route and Dosage Regimen Affect Adherence? a Cohort Study." International Orthopaedics, vol. 44, no. 2, 2020, pp. 237-243.
Moreno JP, Bautista M, Castro J, et al. Extended thromboprophylaxis for hip or knee arthroplasty. Does the administration route and dosage regimen affect adherence? A cohort study. Int Orthop. 2020;44(2):237-243.
Moreno, J. P., Bautista, M., Castro, J., Bonilla, G., & Llinás, A. (2020). Extended thromboprophylaxis for hip or knee arthroplasty. Does the administration route and dosage regimen affect adherence? A cohort study. International Orthopaedics, 44(2), pp. 237-243. doi:10.1007/s00264-019-04454-3.
Moreno JP, et al. Extended Thromboprophylaxis for Hip or Knee Arthroplasty. Does the Administration Route and Dosage Regimen Affect Adherence? a Cohort Study. Int Orthop. 2020;44(2):237-243. PubMed PMID: 31807853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extended thromboprophylaxis for hip or knee arthroplasty. Does the administration route and dosage regimen affect adherence? A cohort study. AU - Moreno,Juan P, AU - Bautista,Maria, AU - Castro,Jorge, AU - Bonilla,Guillermo, AU - Llinás,Adolfo, Y1 - 2019/12/06/ PY - 2019/07/27/received PY - 2019/11/11/accepted PY - 2019/12/7/pubmed PY - 2019/12/7/medline PY - 2019/12/7/entrez KW - Arthroplasty KW - Hip KW - Prevention & control KW - Replacement KW - Venous thromboembolism SP - 237 EP - 243 JF - International orthopaedics JO - Int Orthop VL - 44 IS - 2 N2 - PURPOSE: Prevention of thromboembolic disease requires patients' adherence to the extended thromboprophylaxis scheme. Oral anticoagulants are expected to improve adherence as a result of their route of administration; however, this assumption is yet to be confirmed. The purpose of this study was to assess the impact of the route of administration and dosage regimen on the compliance to the prescription. MATERIALS AND METHODS: This prospective cohort study included hip and knee arthroplasty patients who received pharmacological extended thromboprophylaxis with one daily injection, one daily oral tablet, or two daily oral tablets. A telephonic questionnaire was applied 35 days after the day of the surgery. Patients who omitted one or more doses of medication during the follow-up period were classified as "non-adherent." Differences of adherence rates were assessed. RESULTS: Five hundred and twenty patients were included: 153 received Apixaban (oral, twice a day), 155 Enoxaparin (injectable, once a day), and 212 Rivaroxaban (oral, once a day). Patients receiving oral once a day medication was more compliant compared with those who received an oral medication twice a day. Non-adherence rates were 3.2 and 9.2%, respectively (p = 0.033). No significant differences (p = 0.360) were found between oral once a day and injectable once a day medication. CONCLUSIONS: The number of daily doses prescribed was related to adherence to extended chemical prophylaxis, while the route of administration did not seem to have a significant impact. Strategies to promote outpatient compliance must be implemented, especially when regimes including more than one daily dose are prescribed. SN - 1432-5195 UR - https://www.unboundmedicine.com/medline/citation/31807853/Extended_thromboprophylaxis_for_hip_or_knee_arthroplasty._Does_the_administration_route_and_dosage_regimen_affect_adherence_A_cohort_study L2 - https://dx.doi.org/10.1007/s00264-019-04454-3 DB - PRIME DP - Unbound Medicine ER -