title: [Adherence to and satisfaction with oral outpatient thromboembolism prophylaxis compared to parenteral: SALTO study].
abstract: BACKGROUND
  Prolongation of drug-based thromboembolism prophylaxis after discharge from hospital is clearly recommended following total hip and knee replacement. The aim of this study was to evaluate and compare adherence to and satisfaction with outpatient thromboembolism prophylaxis (by injection and oral) under routine clinical practice conditions.
  
  
  METHODS
  We analysed two consecutive cohorts of patients (480 and 366, respectively) who had undergone total hip or knee replacement surgery in 120 Spanish hospitals, and were prescribed outpatient thromboembolism prophylaxis, by injection and orally, respectively. Information on adherence to and satisfaction with both treatments, sociodemographic data and treatment compliance was collected using specific questionnaires.
  
  
  RESULTS
  The drop-out rate (9.49 vs. 4.14%), general satisfaction (37 vs. 83.38%), and the TSQM satisfaction scale were better in the oral prophylaxis cohort and, although the differences between the two routes of administration were not significant, treatment compliance was also better in the oral cohort (Morisky-Green test: 53.49 vs. 59.05%).
  
  
  CONCLUSIONS
  Adherence to and satisfaction with the oral thromboembolism prophylaxis were better than for prophylaxis by injection in the context of outpatient prolongation. Nevertheless, suboptimal treatment compliance was found in both cohorts, which could result in lack of efficacy of the prophylaxis. Both patients and doctors have to be made aware of the importance of post-discharge extension of thromboprophylaxis in orthopaedic surgery with high thrombotic risk. Moreover, strategies should be developed to encourage compliance.
authors.affiliation: Sección Cirugía Ortopédica, Servicio de Cirugía Ortopédica y Traumatología, Grupo de Estudio del Tromboembolismo de la SECOT, Hospital Clínic, Barcelona, España. lpeidro@clinic.ub.es
authors.forename: L
authors.initials: L
authors.lastname: Peidro-Garcés
authors.forename: R
authors.initials: R
authors.lastname: Otero-Fernandez
authors.forename: L
authors.initials: L
authors.lastname: Lozano-Lizarraga
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D000069604:Dabigatran; D005260:Female; D000077425:Fondaparinux; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage / Q000627:therapeutic use; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control; D000069552:Rivaroxaban; D013030:Spain; D011795:Surveys and Questionnaires; D013876:Thiophenes / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D016903:Drug Monitoring
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D006495:Heparin, Low-Molecular-Weight; D009025:Morpholines; D011134:Polysaccharides; D013876:Thiophenes; D015091:beta-Alanine; D000069552:Rivaroxaban; D000069604:Dabigatran; D000077425:Fondaparinux