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International Journal of Clinical Pharmacy

, Volume 40, Issue 3, pp 543–549 | Cite as

Venous thromboembolism prophylaxis in mental health in-patient services: a qualitative study

  • Audrey PurcellEmail author
  • Mary Clarke
  • Ian Maidment
Research Article

Abstract

Background Venous thromboembolism (VTE) is an important and potentially preventable cause of morbidity and mortality in hospitalised patients. It is a significant, international patient safety issue affecting medical, surgical and mental health in-patients. There is a paucity of published evidence on the incidence of VTE, and the role of VTE risk-assessment and prophylaxis, in mental healthcare settings. Epidemiological evidence indicates that antipsychotic medications are an independent risk factor for VTE. Objective To explore healthcare practitioners’ experiences and perspectives regarding VTE prophylaxis for in-patients in mental health services in Ireland. Setting This study was conducted in two national teaching hospitals in Dublin, Ireland. Method This experiential, qualitative study was conducted using face-to-face, semi-structured interviews. Purposive sampling was used to allow strategic selection of participants from the pharmacy, medical and nursing disciplines. Data was analysed using inductive thematic analysis. Consolidated criteria for reporting qualitative studies guidelines were used as a reporting framework. Main outcome measure Participants’ views on VTE prophylaxis for mental health in-patients. Results Five key themes were derived: risk factors in mental health, attitudes to risk-assessment, challenges with VTE prophylaxis, lack of awareness, and lack of evidence in mental health. Conclusion The results indicate considerable diversities in perceived risk of VTE, and in experiences with VTE risk-assessment and prophylaxis. VTE risk was considered in practice specifically for immobile, older adults and eating disorder patients on bed rest. Specific research is required to address this area of clinical uncertainty in mental health.

Keywords

Deep Vein Thrombosis Ireland Mental health Psychiatry Pulmonary Embolism Venous thromboembolism 

Notes

Acknowledgements

We acknowledge the contribution of Dr Consilia Walsh, St Vincent’s University Hospital, Dublin to the participant selection and recruitment process. We acknowledge the contribution of participants from both Saint John of God Hospital, and St Vincent’s University Hospital, Dublin.

Funding

None.

Conflicts of interest

No conflict of interest declared for each author and contributor.

Supplementary material

11096_2018_599_MOESM1_ESM.pdf (393 kb)
Supplementary material 1 (PDF 393 kb)
11096_2018_599_MOESM2_ESM.xml (63 kb)
Supplementary material 2 (DOCX 62 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Saint John of God HospitalStillorgan, Co DublinIreland
  2. 2.Aston UniversityBirminghamUK

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