Analysis of Drug Compliance among Patients Suffering from Deep Vein Thrombosis

Objective: The objective of current research was to identify the compliance of commonly prescribed antithrombotic drug among patients who suffering from Deep Vein Thrombosis (DVT). Methodology: Descriptive cross-sectional research on adults with age of 18-65 years suffering from DVT were conducted on medicine department of Shaheed Mohtarma Benazir Bhutto Medical University Hospital of Larkana. Three hundred and forty eight DVT patients were consecutive selected during the period of six months from January 2021 to June 2021. Data of DVT patients was collected by using standard proforma and analyzed with statistical package of social sciences (SPSS) version 25. Results: Majority of DVT patients evaluated during study period were male 237 (61.7%) patients and 147 (38.3%) DVT patients were female. Mean age of DVT patients was 43.78 ± 12.43 (18-65) years. Most of the patients were in age group of 51-65 years having 126 (32.8%) patients followed by 41-50 years having 104 (27.1%) patients, 31-40 years having 93 (24.2%) patients and 18-30 years having 61 (15.9%) patients. Majority of DVT patients were from urban areas 217 (56.5%) patients followed by rural areas 167 (43.5%) patients. Drug compliance in illiterate patients was 107 (36.1%). Drug compliance in indoor job patients was 102 (34.5%) whereas drug compliance in jobless patients was 59 (19.1%). Drug compliance in positive medication history was 207 (69.9%). Drug compliance in Hypertensive patients was 33 (11.1%) in congestive heart failure patients 27 (9.1%), in ischemic stroke 15 (5.1%). Whereas, the drug compliance among diabetes mellitus patients was 13 (4.4%). Overall drug compliance with antithrombotic drugs was reported in 296 (77.1%) DVT patients. Conclusion: Current research concludes that rate of drug compliance was high in patients of DVT with rivaroxaban followed by warfarin and heparin, whereas long duration of therapy, polypharmacy, side effects of therapy, cost of therapy, continuous monitoring, injectables, diet restrictions and ADRs of therapy were the most commonly reported factors of non-compliance.

Download Full-text

Comparative Study of Compliance and Factors Affecting Compliance among Commonly Used Drugs in Deep Vein Thrombosis Patients

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i47a33007 ◽

2021 ◽

pp. 221-229

Author(s):

Sajid Ali ◽

Kheraj Mal ◽

Jaghat Ram ◽

Rukhsana Malik ◽

Muhammad Aslam Abbassi ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Side Effects ◽

Drug Compliance ◽

Cross Sectional ◽

Factors Affecting ◽

Vein Thrombosis ◽

Validated Questionnaire ◽

Patient Consent ◽

Therapy Cost ◽

Deep Vein

Objectives: The objective of current research was to identify the compliance of antithrombotic drug (heparin, warfarin and Rivaroxaban) and factors of non-compliance associated with heparin, warfarin and rivaroxaban. Methodology: A cross-sectional, observational study was conducted on patients suffering from Deep Vein Thrombosis (DVT) at government teaching hospital of Larkana. 348 DVT patients were selected by using online sample calculator software. Data was collected by using pre validated questionnaire after taking patient consent; finally the data was analyzed with statistical package of social sciences (SPSS) version 25. Results: The compliance with rivaroxaban was present in 103 (80.5%) patients followed by heparin drug compliance in 95 (74.2%) DVT patients and warfarin drug compliance in 98 (76.6%) DVT patients. Non-compliance factors with rivaroxaban were; cost in 4 (16.0%) patients, polypharmacy in 6 (24.0%) patients, side effects in 4 (16.0%) patients and prolong therapy in 11 (44.0%) patients. Non-compliance factors with heparin were; monitoring in 13 (39.4%) patients, diet restriction in 6 (18.2%) patients, injectable in 10 (30.3%) patients and ADR in 4 (12.1%) patients. Non-compliance factors with warfarin were; cost in 4 (13.3%) patients, polypharmacy in 8 (26.7%) patients, prolong therapy in 5 (16.7%) patients and ADR in 13 (43.3%) patients. Conclusion: This study concludes that rate of drug compliance was high in patients of DVT with rivaroxaban followed by warfarin and heparin, whereas long duration of therapy, polypharmacy, side effects of therapy, cost of therapy, continuous monitoring, injectables, diet restrictions and ADRs of therapy were the most commonly reported factors of non-compliance.

Download Full-text

Prevalence of deep vein thrombosis in patients with paraplegia caused by traumas

Jornal Vascular Brasileiro ◽

10.1590/jvb.2013.051 ◽

2013 ◽

Vol 12 (4) ◽

pp. 271-277

Author(s):

Nelson Mesquita Junior ◽

Flavia Natalia Marques Kingerski ◽

Giovana Liz Marioto ◽

Fabio Alex Fonseca Viegas ◽

Suzelaine Fidelis da Silva Mesquita ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Doppler Ultrasonography ◽

Color Doppler ◽

Color Doppler Ultrasonography ◽

University Hospital ◽

Venous Stasis ◽

Common Disease ◽

Cross Sectional ◽

Vein Thrombosis ◽

Deep Vein

BACKGROUND: Deep vein thrombosis is a common disease among people who are immobilized. Immobility is inherent to paraplegia and leads to venous stasis, which is one of the factors covered by Virchow's triad describing its development. Trauma is the primary cause of paraplegia and is currently increasing at a rate of 4% per year. OBJECTIVE: To determine the prevalence of deep vein thrombosis in paraplegic patients whose paraplegia was caused by traumas, using color Doppler ultrasonography for diagnosis. METHODS: This was a cross-sectional observational study of 30 trauma-induced paraplegia patients, selected after analysis of medical records at the neurosurgery department of a University Hospital in Curitiba, Brazil, and by a proactive survey of associations that care for the physically disabled. The prevalence of deep vein thrombosis was analyzed using 95% confidence intervals. RESULTS: Spinal cord trauma was the cause of paraplegia in 29 patients. The most common cause of trauma was gunshot wounding, reported by 17 patients. Deep vein thrombosis was diagnosed by color Doppler ultrasonography in 14 patients in the sample. The most often affected vein was the posterior tibial, in 11 patients. The left lower limb was involved three times more often than the right. Edema was observed in 25 individuals, cyanosis in 14, ulcers in 8 and localized increase in temperature in 13. CONCLUSIONS: Deep vein thrombosis was prevalent, occurring in 46.7% of the patients.

Download Full-text

Predictors of long-term post-thrombotic syndrome following high proximal deep vein thrombosis: a cross-sectional study

Thrombosis Journal ◽

10.1186/s12959-020-00253-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Marit Engeseth ◽

Tone Enden ◽

Per Morten Sandset ◽

Hilde Skuterud Wik

Keyword(s):

Deep Vein Thrombosis ◽

Proximal Deep Vein Thrombosis ◽

Cross Sectional ◽

Clinical Criteria ◽

Vein Thrombosis ◽

Post Thrombotic Syndrome ◽

Younger Age ◽

Deep Vein

Abstract Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT. Methods During 2006–09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (> 1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression. Results Eighty-eight patients (52%) were included 8–10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93–0.99), and 1.23 (95% CI, 1.02–1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments. Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.

Download Full-text

Long-Term Prevalence of Disaster-Related Deep Vein Thrombosis in Minamiaso Village After the 2016 Kumamoto Earthquakes: A Prospective Cross-Sectional Analysis

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.271 ◽

2021 ◽

pp. 1-8

Author(s):

Hidenori Onishi ◽

Osamu Yamamura ◽

Hiromasa Tsubouchi ◽

Takeshi Hirobe ◽

Ikuko Kosugi ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Recovery Phase ◽

Cross Sectional ◽

Portable Ultrasound ◽

Entire Cohort ◽

Vein Thrombosis ◽

The 2016 Kumamoto Earthquakes ◽

Long Time ◽

Deep Vein ◽

2016 Kumamoto Earthquakes

Abstract Objective: This study aimed to examine the prevalence of deep vein thrombosis (DVT) among evacuees in Minamiaso, a village which was temporarily isolated after the earthquakes, from the acute to recovery phase after the 2016 Kumamoto Earthquakes (GLIDE no: EQ-2016-000033-JPN). Methods: This prospective study, which was approved by Fukui University Medical Research Ethics Committee (approval no. 20160024 and 20160089), enrolled 181 evacuees (73.9 ± 11.6 y) who participated in a series of 3 DVT screenings using portable ultrasound machines conducted over 19 mo. All participants completed a questionnaire before the screenings, and none of the participants attended all 3 screenings. Data analysis was performed using EZR version 1.41. Results: The DVT prevalence was 14.3% (79.4 ± 8.2 y) at first screening of evacuees staying in shelters and 18.5% (71.5 ± 13.1 y) and 12.2% (72.8 ± 10.9 y) in second and third screenings of evacuees staying in temporary housing, respectively. Multivariate analysis revealed age ≥75 y and alcohol consumption as independent risk factors in the entire cohort and in patients aged ≤74 y, respectively. Conclusions: A high DVT prevalence over a long time period of 19 mo was observed where survivors were temporarily isolated after the disaster.

Download Full-text

Commentary on the screening for occult lower-extremity deep-vein thrombosis upon admission to acute inpatient rehabilitation: A cross-sectional, prospective study

The Journal of the International Society of Physical and Rehabilitation Medicine ◽

10.4103/jisprm.jisprm_50_19 ◽

2019 ◽

Vol 2 (3) ◽

pp. 115

Author(s):

MansiM Jhaveri ◽

MaryE Russell

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Prospective Study ◽

Inpatient Rehabilitation ◽

Cross Sectional ◽

Vein Thrombosis ◽

Deep Vein

Download Full-text

Patient adherence to rivaroxaban in deep vein thrombosis, a cohort study in Switzerland: quantitative results

International Journal of Clinical Pharmacy ◽

10.1007/s11096-019-00928-x ◽

2019 ◽

Vol 41 (6) ◽

pp. 1625-1633

Author(s):

Jennifer Dotta-Celio ◽

Adriano Alatri ◽

Isabella Locatelli ◽

Monique Salvi ◽

Olivier Bugnon ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Medication Adherence ◽

Electronic Monitoring ◽

Patient Adherence ◽

Survival Curve ◽

Vitamin K Antagonists ◽

University Hospital ◽

Fixed Dose ◽

Vein Thrombosis ◽

Deep Vein

AbstractBackground Direct oral anticoagulants (DOACs) have the advantage of being administered orally at a fixed dose without laboratory monitoring, in contrast to the frequent international normalized ratio measurements used to adjust for vitamin K antagonists dosing. Rivaroxaban, has a short half-life. The anticoagulation effect rapidly decreases if medication adherence is suboptimal. Objective The purpose of this quantitative study (called RIVA) is to longitudinally describe adherence to rivaroxaban (implementation and persistence) in patients with deep vein thrombosis (DVT). Setting The community pharmacy of the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland in collaboration with the angiology division of the Lausanne University Hospital (CHUV). Methods This is an observational study. Patients received rivaroxaban for 3 or 6 months: 15 mg twice a day during the first 3 weeks and then 20 mg once a day until the end of the treatment. Adherence was measured using electronic monitoring. Implementation and adherence were modelled using a generalized estimating equation model. Persistence was represented using a Kaplan–Meier survival curve. Main outcome measure Medication adherence (implementation and persistence). Results Thirty-one consecutive patients were included (68% male, mean age: 47 years old). The collected adherence data consisted of 57 inter-visit phases, 2899 electronic monitoring openings and a median follow-up of 92 days (IQR: 87; 100). Implementation to rivaroxaban was initially high [96.3 (92.8; 98.1)] but decreased during the first 3 weeks, until it reached 89.3 (76.0; 95.6). After the switch from twice a day 15 mg to a once a day 20 mg regimen, implementation increased again and remained stable [95.4 (92.2; 97.3)] for 90 days. Four patients who experienced adverse events discontinued the treatment before the end of the study and were considered non-persistent (clinically appropriate discontinuation). Conclusion Adherence to rivaroxaban in deep vein trombosis is high in persistent patients. Discontinuation is related to rivaroxaban adverse effects/toxicity. Implementation should be reinforced during the twice a day-phase, and this first 3-week experience should help patients and healthcare professionals choose the best timing for the once a day phase.

Download Full-text

Predicting Venous Thromboembolic Events in Patients with Coronavirus Disease 2019 Requiring Hospitalization: an Observational Retrospective Study by the COVIDIC Initiative in a Swiss University Hospital

BioMed Research International ◽

10.1155/2020/9126148 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Eleftheria Kampouri ◽

Paraskevas Filippidis ◽

Benjamin Viala ◽

Marie Méan ◽

Olivier Pantet ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Retrospective Study ◽

University Hospital ◽

Thromboembolic Events ◽

Vein Thrombosis ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Wells Score ◽

Deep Vein ◽

D Dimer

Background. Coronavirus disease 2019 (COVID-19) can result in profound changes in blood coagulation. The aim of the study was to determine the incidence and predictors of venous thromboembolic events (VTE) among patients with COVID-19 requiring hospital admission. Subjects and Methods. We performed a retrospective study at the Lausanne University Hospital with patients admitted because of COVID-19 from February 28 to April 30, 2020. Results. Among 443 patients with COVID-19, VTE was diagnosed in 41 patients (9.3%; 27 pulmonary embolisms, 12 deep vein thrombosis, one pulmonary embolism and deep vein thrombosis, one portal vein thrombosis). VTE was diagnosed already upon admission in 14 (34.1%) patients and 27 (65.9%) during hospital stay (18 in ICU and nine in wards outside the ICU). Multivariate analysis revealed D-dimer value > 3,120 ng / ml ( P < 0.001 ; OR 15.8, 95% CI 4.7-52.9) and duration of 8 days or more from COVID-19 symptoms onset to presentation ( P 0.020; OR 4.8, 95% CI 1.3-18.3) to be independently associated with VTE upon admission. D-dimer value ≥ 3,000 ng / l combined with a Wells score for PE ≥ 2 was highly specific (sensitivity 57.1%, specificity 91.6%) in detecting VTE upon admission. Development of VTE during hospitalization was independently associated with D-dimer value > 5,611 ng / ml ( P < 0.001 ; OR 6.3, 95% CI 2.4-16.2) and mechanical ventilation ( P < 0.001 ; OR 5.9, 95% CI 2.3-15.1). Conclusions. VTE seems to be a common COVID-19 complication upon admission and during hospitalization, especially in ICU. The combination of Wells ≥ 2 score and D − dimer ≥ 3,000 ng / l is a good predictor of VTE at admission.

Download Full-text

Venous Insufficiency 4 Years after an Episode of Deep Vein Thrombosis: A Clinical and Plethysmographic Investigation

Phlebology The Journal of Venous Disease ◽

10.1177/026835559801300205 ◽

1998 ◽

Vol 13 (2) ◽

pp. 53-58

Author(s):

M. Nordström ◽

B. Lindblad ◽

H. Åkesson ◽

D. Bergqvist ◽

T. Kjellström

Keyword(s):

Deep Vein Thrombosis ◽

Venous Insufficiency ◽

Outcome Measure ◽

Clinical Symptoms ◽

University Hospital ◽

Vein Thrombosis ◽

Venous Function ◽

Deep Vein ◽

Symptoms And Signs

Objective: To evaluate the frequency of venous insufficiency following deep vein thrombosis (DVT). Design: Follow-up 4 years after a verified DVT. Setting: University hospital in Malmö. Patients: Eighty-seven subjects with venographically verified DVT. Main outcome measure: To compare venous function in legs, with and without previous DVT, by venous straingauge plethysmography and its correlation with clinical symptoms and signs. Results: Fifty-two per cent of patients described general discomfort from the thrombotic leg at follow-up. Active leg ulcers were found in three patients (3%); there were no signs of venous insufficiency in 33% at clinical examination. Thirty-seven patients (75%) with ≥ 1 cm difference in calf circumference between the thrombotic and contralateral leg had suffered a proximal DVT. The refilling time T90 was pathological in 67% and the muscle pump function (RV) in 55%. In the nonthrombotic leg the corresponding figures were 53% and 40%. Nevertheless a positive correlation was found between RV of the thrombotic leg and the contralateral leg ( r = 0.33) but an even stronger correlation was found for T90 ( r = 0.74). Conclusion: Venous insufficiency was found in 60% of legs 4 years after DVT but was also found in 14% of legs without previous thrombosis. This may be caused not only by effects of the thrombosis but also by the ageing process.

Download Full-text