title: Assessment of a self-administration protocol for extended subcutaneous thromboprophylaxis in lower limb arthroplasty.
abstract: The risk of venous thromboembolism in patients following arthroplasty may be reduced by continuing chemical thromboprophylaxis for up to 35 days post-operatively. This prospective cohort study investigated the compliance of 40 consecutive consenting patients undergoing lower limb arthroplasty with self-administration of a recommended subcutaneous chemotherapeutic agent for six weeks after surgery. Compliance was assessed by examination of the patient for signs of injection, number of syringes used, and a self-report diary at the end of the six-week period. A total of 40 patients, 15 men and 25 women, were recruited. One woman was excluded because immediate post-operative complications prevented her participation. Self-administration was considered feasible in 87% of patients (95% confidence interval (CI) 76 to 98) at the time of discharge. Among this group of 34 patients, 29 (85%) were compliant (95% CI 73 to 97). Patients can learn to self-administer subcutaneous injections of thromboprophylaxis, and compliance with extended prophylaxis to six weeks is good.
authors.affiliation: Elective Orthopaedic Unit New Royal Infirmary, Little France, Old Dalkeith Road, Edinburgh EH16 4SU, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Watts
authors.forename: C R
authors.initials: CR
authors.lastname: Howie
authors.forename: A H R W
authors.initials: AH
authors.lastname: Simpson
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005240:Feasibility Studies; D005260:Female; D000077425:Fondaparinux; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D010349:Patient Compliance; D011134:Polysaccharides / Q000008:administration & dosage / Q000009:adverse effects; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012646:Self Administration; D013923:Thromboembolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D011134:Polysaccharides; D000077425:Fondaparinux