KNOWLEDGE, ATTITUDE AND PRACTICES OF HEALTHCARE PROVIDERS TOWARDS DEEP VEIN THROMBOSIS PROPHYLAXIS IN FIVE TEACHING HOSPITALS OF RAWALPINDI

Authors

  • Ahsin M Bhatti
  • Sadia Ahsin
  • Babur Salim
  • Junaid Mansoor

Abstract

Background: Prophylaxis of deep vein thrombosis (DVT) is underutilised in Pakistan. This crosssectional survey was designed to evaluate knowledge, attitude and practices of healthcareproviders towards DVT prophylaxis in teaching hospitals in and around Rawalpindi. Methods:Knowledge, attitude and practices was assessed by a 12-item questionnaire filled-in by healthcareproviders in five teaching hospitals. Eleven out of 12 questions were multiple-choice type and onewas open ended. Results: One hundred-sixty-nine, out of 200 questionnaires were returned andwere analysed. Total 43.2% of the respondents were house-officers. Although 98.8% agreed thatDVT prophylaxis is clinically important, but 39.4% actually prescribed it themselves. Out ofthese, only 10.3% respondents did it routinely. Low molecular weight heparin (LMWH) was thepreferred prophylaxis used (36.7%). Most of the respondents underestimated the prevalence andconsequences of DVT in hospitalised patients. Conclusion: Knowledge and practices ofhealthcare providers about DVT prophylaxis in hospitalised patients is less than ideal. Hospitalsneed to develop their own guidelines for DVT prophylaxis.Keywords: Knowledge, Attitude, Practices, DVT Prophylaxis, Pakistan

References

Anderson FA, Wheeler HB, Goldberg RJ. A populationbased perspective of the hospital incidence and case-fatality

rates of deep vein thrombosis and pulmonary embolism: the

Worcester DVT Study. Arch Intern Med 1991;151:933–8.

Clagett GP, Anderson FA Jr, Greets W, et al. Prevention of

venous thromboembolism. Chest 1998;114:531–60.

Sandler DA, Martin JF. Autopsy proven pulmonary embolism

in hospitalised patients: are we detecting enough deep vein

thrombosis? J R Soc Med 1989;82:203–5.

Prandoni P, Villalta S, Bagatella P, Ross Li, Marchiori A,

Piccioli A, et al. The clinical course of deep-vein thrombosis.

Prospective long-term follow-up of 528 symptomatic patients.

Haematologica 1997;82:423–8.

Geerts WH, Heit JA, Clagett GP. Prevention of venous

thromboembolism. Chest 2001;119:132S–175S.

Prevention of fatal pulmonary embolism by low doses of

heparin. The Lancet 1975;306:45–51.

Group Second Thromboembolic Risk Factors (THRiFT II)

Consensus Risk of and prophylaxis for venous

thromboembolism in hospital patients. Phlebology

;13:87–97.

Clagett GP, Anderson Jr FA, Levine MN, Salzman EW,

Wheeler HB. Prevention of venous thromboembolism. Chest

;102(4Suppl):391S–407S.

Greets WH, Pineo GF, Heit JA. Prevention of venous

thromboembolism: the Seventh ACCP Conference on

Antithrombotic and thrombolytic Therapy. Chest 2004;126(3

suppl):338S–400S.

Yu HT, Dylan ML, Lin J, Dubois RW Hospital’s compliance

with prophylaxis guidelines for venous thromboembolism.

Am J Health Sys Pharm 2007;64:69–76.

Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar

AK, Deslandes B, et al. Venous Thromboembolism risk and

orophylaxis in acute hospital care setting (ENDORSE study): a

multinational cross sectional study. Lancet 2008;371:387–94.

Akbar MN, Salahuddin O, Zafarullah O. A clinical audit on

venous thromboembolism prophylaxis of medical patients in

West Medical Ward, Mayo Hospital. Ann King Edward Med

Uni 2006;12(2):328–30.

Bilal N. Prophylactic anticoagulation for perioperative deep

venous thrombosis. J Pak Inst Med Sci 2001;8:603–5.

Nicolaides AN, Breddin HK, Fareed J, Goldhaber S, Haas S,

Hull R, et al. Prevention of venous thromboembolism.

International Consensus Statement. Guidelines compiled in

accordance with the scientific evidence. Int Angiol

;20:1–37.

Mirza W, Ashraf S, Fawad A. Role of routine use of

thromboprophylaxis in patients undergoing major surgery.

Pak J Med Res 2005;44:4–11.

Aziz I. Frequency of postoperative deep vein thrombosis in

high-risk surgical patients. J Coll Physicians Surg Pak

;15:299–301.

Majeed N, Shah MQA, Malik SA. Deep vein thrombosis in

pelvic and femoral fractures in Earth Quake victims. Pak

Armed Forces Med J 2006;56:347–50.

Philbrick JT, Becker DM. Calf deep venous thrombosis: a

wolf in sheep’s clothing? Arch Intern Med 1988;148:2131–8.

Agnelli G, Cosmi B, Radicchia S. Features of thrombi and

diagnostic accuracy of impedance plethysmography in

symptomatic and asymptomatic deep vein thrombosis.

Thromb Haemost 1993;70:266–9.

Haas SB, Tribus CB, Insall JN, Becker MW, Windsor RE.

The significance of calf thrombi after total knee arthroplasty.

J Bone Joint Surg 1992;74:799–802.

Kalodiki E, Domjan J, Nicolaides AN, Cunningham DA, alKutoubi A, Birch R, et al. V/Q defects and deep venous

thrombosis following total hip replacement. Clin Radio

;50:400–3.

Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration

prophylaxis against venous thromboembolism after total hip

or knee replacement: a meta-analysis of the randomised trials.

Lancet 2001;358:9–15.

Alikhan R, Peters F, Wilmott R, Cohen AT. Fatal Pulmonary

embolism in hospitalised patients: a necropsy review. J Clin

Pathol 2004;57:1254–7.

Krishnaswamy A, Lincoff AM, Cannon CP. The use and

limitations of unfractionated heparin. Crit Pathw Cardiol

;9(1):35–40

Downloads

Published

2012-06-01