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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(05): 647-655
DOI: 10.1055/s-0041-1731657
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Thromboembolism in Arthroplasty: Compliance to Prophylaxis[*]

Article in several languages: português | English
Leandra Marla Aires Travassos Viana 
1   Setor de Farmácia, Unidade de Farmácia Clínica, Hospital Universitário, Universidade Federal do Maranhão, São Luís, MA, Brasil
,
Iara Antônia Lustosa Nogueira 
1   Setor de Farmácia, Unidade de Farmácia Clínica, Hospital Universitário, Universidade Federal do Maranhão, São Luís, MA, Brasil
,
Andréa Martins Melo Fontenele 
2   Disciplinas de Farmácia Hospitalar e Farmacologia Clínica, Departamento de Farmácia, Universidade Federal do Maranhão, São Luís, MA, Brasil
,
Liszt Palmeira de Oliveira 
3   Programa de Pós-graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Abstract

Objective The present paper aims to identify the profile of compliance to thromboembolism drug prophylaxis in patients undergoing knee or hip arthroplasty at a public hospital.

Methods This is a prospective cohort study, carried out from August 2017 to September 2018, with adult patients who were followed-up from admission until the postoperative period. The Morisky Medication Adherence Scale, consisting of eight items, was applied. Compliance was quantified according to the sum of all correct answers as high (8 points), medium (6 to < 8 points), and low compliance (< 6 points). For the present study, subjects with high compliance were referred as highly compliant, whereas those with medium to low compliance were referred as partially compliant.

Results The compliance analysis showed that 73.0% of the patients were highly compliant and 27.0% were partially compliant to thromboprophylaxis. The anticoagulant prescribed at hospital discharge was rivaroxaban, a direct factor Xa inhibitor. Compliance was greater in patients who did not require reinforcement in prophylaxis guidance during follow-up; these subjects reported good and excellent acceptance of prophylaxis, although they were on multiple medications at discharge.

Conclusion The data analysis allowed us to conclude that the factors that most influenced compliance were the levels of understanding and acceptance of prophylaxis by the patients, the amount of medication used per day by the subject, the cost of the anticoagulant agent, and its potential to cause adverse reactions.

Keywords

treatment adherence - anticoagulants - arthroplasty - prophylaxis - thromboembolism

Financial Support

There was no financial support from public, commercial, or non-profit sources.


* Study developed at the Hospital Universitário da Universidade Federal do Maranhão, São Luís, MA, Brazil




Publication History

Received: 10 March 2020

Accepted: 11 February 2021

Article published online:
20 September 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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