No difference in patient compliance between full-strength versus low-dose aspirin for VTE prophylaxis following total hi
- PDF / 897,504 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 11 Downloads / 162 Views
ORIGINAL ARTICLE
No difference in patient compliance between full‑strength versus low‑dose aspirin for VTE prophylaxis following total hip and total knee replacement Brandon Hood1 · Bryan Springer1 · Susan Odum2 · Brian M. Curtin1 Received: 22 August 2020 / Accepted: 10 November 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Introduction The utilization of aspirin for VTE prophylaxis following TJA has increased due to updated clinical practice guidelines. Aspirin is the only approved VTE prophylaxis medication that does not require a prescription, but adherence and tolerance remain unknown. We hypothesized decreased patient compliance utilizing full-strength 325 mg aspirin twice daily following TJA when compared to low-dose 81 mg twice daily. We also investigated the reasons why patients may elect to stop the medication earlier than 28 days. Methods A consecutive series of patients undergoing primary total hip or knee arthroplasty utilizing 325 or 81 mg of EC aspirin twice daily for 4 weeks were surveyed to determine compliance with use and any adverse events related to the medication. Fisher’s exact test was used to determine statistical significance. Results 404 patients were enrolled with 199 patients prescribed the 325 mg regimen. Fifty-two patients who were prescribed 325 mg missed a dose versus 51 patients who were prescribed 81 mg (p = 0.082). No significant difference in the frequency of missed doses (missing 10 doses) between the treatment regimens (p = 0.78, 0.39 and 0.83, respectively). Most commonly cited reason for stopping aspirin in both treatment groups was gastrointestinal issues (10.5% and 7%, respectively). Discussion and Conclusions By surveying patients on their use of aspirin we find no difference in adherence between fullstrength and low-dose treatment regimens. Additionally, we have a better understanding of the reasons for noncompliance as GI upset was a relatively common complaint with both doses. Keywords DVT prophylaxis · Total joint replacement · Aspirin · Medication compliance
Introduction Venous thromboembolism (VTE) is a concern for all patients undergoing total hip or knee replacement. In 1984, a case series highlighted the occurrence of a deep vein thrombosis (DVT) in 84% of patients not on a VTE prophylactic regimen. Additionally, the incidence of a symptomatic pulmonary embolism in this case series was 1.7% [1].The data led the authors to recommend VTE prophylactic measures * Brian M. Curtin [email protected] 1
OrthoCarolina Hip and Knee Center, 2001 Vail Avenue, Ste 200A, Charlotte, NC 28207, USA
Odum OrthoCarolina Research Institute, 2001 Vail Avenue, Charlotte, NC 28207, USA
2
following total knee arthroplasty. Historically the most commonly used VTE prophylaxis has been warfarin with routine blood draws to appropriately dose the medication [2–5]. The recent publication of new evidence has led to changes in guidelines for DVT prophylaxis have opened the door to the use of aspirin alone without the restraints of blood w
Data Loading...
