Title

Adherence to mechanical thromboprophylaxis after surgery: A systematic review and meta-analysis

Publication Date

2015

Journal Title

Thromb Res

Abstract

BACKGROUND: Many clinical practice guidelines, while recommending mechanical thromboprophylaxis after surgery, have raised concerns that discomfort may result in nonadherence. We therefore addressed adherence to mechanical thromboprophylaxis after surgery. METHODS: We searched MEDLINE from January 1, 2000 to May 21, 2015 for English-language observational studies that assessed patient adherence to mechanical thromboprophylaxis after surgery. We conducted a meta-analysis to estimate average adherence rates. RESULTS: We identified 8 studies (7 for compression devices, 1 for stockings) with median follow up time of 3days. The pooled estimate of adherence for compression devices was 75% (median 78%, range 40%-89%). Studies with shorter follow-up (3days, n=3, pooled adherence 75%) reported similar adherence (p=0.99). The studies varied in definitions of adherence, frequency of assessment, length of follow-up and completeness of reporting. No study followed patients after discharge. CONCLUSIONS: Up to one fourth of patients are nonadherent to mechanical thromboprophylaxis while hospitalized. Clinicians considering the relative merits of mechanical versus pharmacologic prophylaxis should address the issue of adherence. Strategies to improve adherence merit investigation.

Volume Number

136

Issue Number

4

Pages

723-6

Document Type

Article

EPub Date

2015/07/05

Status

Resident

Facility

Northwell Health

Primary Department

Urology

PMID

26140737

DOI

10.1016/j.thromres.2015.06.023