title: Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
abstract: BACKGROUND
  The 2012 American College of Chest Physicians venous thromboembolism prevention guidelines emphasized the importance of considering patient preferences when ordering venous thromboembolism prophylaxis.
  
  
  OBJECTIVE
  Determine patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
  
  
  METHODS
  Single-center, mixed-methods survey.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Consecutive hospitalized patients on surgical and medical units.
  
  
  METHODS
  Patients were asked about their preferences regarding the route of administration for pharmacologic venous thromboembolism prophylaxis and the rationale for their preference. Qualitative analyses of themes were determined from patient rationale.
  
  
  RESULTS
  Of the 227 patients, a majority (60.4%) preferred an oral medication, if equally effective to subcutaneous options. Dislike of needles (30.0%) and pain from injection (27.7%) were identified as rationales for their preference. Patients favoring subcutaneous administration (27.5%) identified a presumed faster onset of action (40.3%) as the primary reason for their preference. Patients with a preference for subcutaneous injections were less likely to refuse prophylaxis than patients who preferred an oral route of administration (37.5% vs 51.3%, P < 0.0001).
  
  
  CONCLUSIONS
  Only medical and surgical patients participated.
  
  
  CONCLUSIONS
  In a sample of consecutive medical and surgical patients, a majority preferred an oral route of administration for prophylaxis. Patients preferring subcutaneous injections were less likely to refuse doses of ordered pharmacologic prophylaxis. These results indicate use of an oral agent for venous thromboembolism prophylaxis may improve adherence and that integrating patient preferences into care may increase delivery of effective prophylaxis and reduce the incidence of venous thromboembolism.
authors.affiliation: Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.forename: Peggy S
authors.initials: PS
authors.lastname: Kraus
authors.forename: Brandyn D
authors.initials: BD
authors.lastname: Lau
authors.forename: Michael B
authors.initials: MB
authors.lastname: Streiff
authors.forename: Elliott R
authors.initials: ER
authors.lastname: Haut
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Hobson
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Shermock
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D065129:Pre-Exposure Prophylaxis / Q000379:methods*; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants