title: Patient compliance with new oral anticoagulants after major orthopaedic surgery: rivaroxaban and dabigatran compared with subcutaneous injection of fondaparinux.
abstract: OBJECTIVE
  the main purpose of our study was to compare patient compliance with the orally administered new oral anticoagulants (NOCs) dabigatran and rivaroxaban compared with subcutaneously injected fondaparinux after major orthopaedic surgery, and to assess patient preference for the oralvssubcutaneous administration route.
  
  
  METHODS
  prophylactic antithrombotic drug therapy with dabigatran (group D; GD, n=32 patients), rivaroxaban (group R; GR, n=38 patients) or fondaparinux (group F; GF, n=30 patients), to prevent deep vein thrombosis, was started immediately after surgery in 100 patients submitted to total hip arthroplasty.
  
  
  RESULTS
  the patients had a mean age of 68.7±11 years and 62% were female. In GD, 87.5% of patients indicated that they preferred oral intake of medications to subcutaneous injection (12.5%). In GR, 84.2% declared a preference for oral administration over subcutaneous injection (15.8%). In GF, a surprisingly high proportion of patients (73.3%; p < 0.001) declared that they preferred subcutaneous administration of medications over the oral route (26.7%). Overall, the rate of compliance with antithrombotic drug therapy was very high, at 99%.
  
  
  CONCLUSIONS
  intake of the NOAs dabigatran and rivaroxaban following hospital discharge is entirely the responsibility of the patient; a high level of patient compliance with these drugs must therefore be demonstrated in order for them to become well accepted within the medical community. The results of this study showed a very high level of compliance both with orally and subcutaneously administered drugs.
  
  
  METHODS
  Level I, randomized clinical study.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Udine, Udine, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: DI Benedetto
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital of Udine, Udine, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Vetrugno
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Udine, Udine, Italy.
authors.forename: Dania
authors.initials: D
authors.lastname: DE Franceschi
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Udine, Udine, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Gisonni
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Udine, Udine, Italy.
authors.forename: Araldo
authors.initials: A
authors.lastname: Causero
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, University Hospital of Udine, Udine, Italy.
authors.forename: Giorgio Della
authors.initials: GD
authors.lastname: Rocca
keywords: compliance; dabigatran; drug administration route; fondaparinux; rivaroxaban; venous thrombosis