Compliance with Self-Administration of Heparin Injections in Outpatients
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- Spahn, G. Eur J Trauma (2002) 28: 104. doi:10.1007/s00068-002-1176-1
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Background: Low molecular weight heparin (LMWH) as daily injection is an essential tool for effective prophylaxis against deep vein thrombosis (DVT) today. Daily self-injection by the patients or their families is common practice. The effectiveness of this measure depends on a high patient compliance. The intention of this study was to explore the rate of patients incompliant with LMWH self-injection according to an anonymous questionnaire.
Patients and Methods: Following knee arthroscopy, data of 207 patients were collected concerning knowledge of DVT, acceptance and compliance with self-injection.
Results: In 16 cases (7.7%), self-injection was rejected, and the injections were given by a nursing service. Of the remaining patients, 160 (77.3%), administered the injections themselves, in 31 patients (15%) members of the family were involved. Only 81.2% of these patients would prefer self-injection in the same situation. Problems with self-injection were seen in 34.8% initially and in 6.3% the whole time. In 54 cases (28.3%), LMWH prophylaxis was not sure. This was due to the forgetting of single injections or an early termination of the therapy. Most importantly, all patients < 20 years had an uncertain prophylaxis.
Conclusions: The compliance with the self-injection of LMWH depends on the knowledge of DVT problems, rating of the individual DVT risk, and general perception of injections. The results of this study show a lower compliance with an acceptance of self-injection than generally postulated. Given the importance of an effective DVT prophylaxis with LMWH, a nursing service should be involved in case of any doubt about outpatient compliance.