KNOWLEDGE, ATTITUDE AND PRACTICES OF HEALTHCARE PROVIDERS TOWARDS DEEP VEIN THROMBOSIS PROPHYLAXIS IN FIVE TEACHING HOSPITALS OF RAWALPINDI
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, PakistanReferences
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
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
