Systematic review of patient preference and adherence to the correct use of graduated compression stockings to prevent deep vein thrombosis in surgical patients.
OBJECTIVE
The aim of this study was to explore patient preference and adherence to thigh and knee length graduated compression stockings for the prevention of deep vein thrombosis in surgical patients.


BACKGROUND
Hospitalised patients are at risk of developing deep vein thrombosis. Mechanical methods of prophylaxis include compression stockings, available as knee or thigh length. Patient adherence to correct stocking use is of critical importance to their effectiveness.


METHODS
Systematic review of quantitative evidence.


METHODS
Eleven databases were searched from inception to 2013 for systematic reviews of compression stockings. Reviews were screened for relevant primary studies and update searches of eight electronic sources were undertaken (2010-2014).


METHODS
Randomised controlled trials and observational studies of surgical patients using compression stockings were quality assessed and data were extracted on patient adherence and preference. A narrative summary is presented.


RESULTS
Nine randomised controlled trials and seven observational studies were included in the systematic review. There was substantial variation between studies in terms of patient characteristics, interventions and methods of outcome assessment.


CONCLUSIONS
Patient adherence was generally higher with knee length than thigh length stockings. However, the studies reflect patient adherence in a hospital setting only, where patients are observed by healthcare professionals; it is likely that adherence reduces once patients have been discharged from hospital. Patients preferred knee length stockings over thigh length stockings. In many clinical settings, any difference in efficacy between thigh length and knee length stockings may be rendered irrelevant by patient preference for and likely better adherence to knee length stockings.
Centre for Reviews and Dissemination, University of York, UK.
Ros
http://orcid.org/0000-0002-8666-8110
R
Wade
Centre for Reviews and Dissemination, University of York, UK.
Fiona
F
Paton
Centre for Reviews and Dissemination, University of York, UK.
Nerys
N
Woolacott
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D010349:Patient Compliance; D057240:Patient Preference; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D053828:Stockings, Compression; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000517:prevention & control* / Q000523:psychology; D055815:Young Adult
anti-embolism stocking; deep vein thrombosis; graduated compression stocking; literature review; nursing; patient adherence; patient preference; systematic review