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Drug use problems with self-injected low-molecular-weight heparins in primary care

  • Clinical Trial
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European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Outpatient subcutaneous therapies are becoming increasingly common. A literature search failed to find produced any studies on application problems pertaining to the self-injection of low-molecular-weight heparins (LMWH) in a heterogeneous outpatient population under daily-life conditions. We therefore designed a study with the aim of recording drug use problems, patient satisfaction, compliance, problems arising from the injection site (abdomen vs. thigh), and residual drug volumes in pre-filled syringes used in self-injection therapy.

Methods

Patients were recruited in community pharmacies by 95 trained Master's students in pharmacy. Data were collected during recruitment and by means of structured questionnaire-based telephone interviews that were carried out at the beginning and the end of the LMWH treatment.

Results

The median age of the 213 patients enrolled in the study was 54 years [interquartile range (IQR) 39–70 years]; of these, 15.5% had their injections administered by a third person. The rate of self-reported non-compliance was 17.1%. At least one relevant problem was recorded in 85.0% of the cases. At the end of the treatment, 38.9% of the patients stated self-administration of the injections required some effort. The preferred injection site was the thigh (68.5%). An overall mean residual drug volume ≥10.0% was detected for 3.9% of the patients. If residual drug was present, a median of 11.2% (IQR 8.6–17.6%) of the total drug volume had not been injected. Patients injecting into the thigh showed a higher risk of leaving residual medication (odds ratio 2.16, 95% confidence interval 1.04–4.51).

Conclusions

Most patients had drug use problems, whereas no clear factors were associated with non-compliance, the injection site (apart from residual drug), and discomfort or effort required (apart from prior injection use).

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Acknowledgments

We would like to thank the participating community pharmacies for their cooperation. We also thank the Master’s students for data collection, the patients for participating in the study, Michael Mittag for his support in the statistical analysis, and Irene Vogel Kahmann, Raphaela von Grünigen, Joëlle Bader, and Paul Lavender for their valuable contributions.

Conflict of interest

This study was supported by Pfizer AG through an unrestricted Investigator-Initiated Research Grant (IIRG).

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Authors and Affiliations

  1. Pharmaceutical Care Research Group, Pharmacenter, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland

    Seraina Mengiardi & Kurt E. Hersberger

  2. Division of Hematology, University Hospital Basel, Spitalstrasse 21/Petersgraben 4, 4031, Basel, Switzerland

    Dimitrios A. Tsakiris

  3. Clinical Pharmacy, Kantonsspital Bruderholz, 4101, Bruderholz, Switzerland

    Markus L. Lampert

Authors
  1. Seraina Mengiardi
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  2. Dimitrios A. Tsakiris
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  3. Markus L. Lampert
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  4. Kurt E. Hersberger
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Corresponding author

Correspondence to Seraina Mengiardi.

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Mengiardi, S., Tsakiris, D.A., Lampert, M.L. et al. Drug use problems with self-injected low-molecular-weight heparins in primary care. Eur J Clin Pharmacol 67, 109–120 (2011). https://doi.org/10.1007/s00228-010-0956-5

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  • DOI: https://doi.org/10.1007/s00228-010-0956-5

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