Key result
Among 180 patients undergoing total hip or knee arthroplasty, the overall rate of satisfaction with post-discharge anticoagulation management was 81.67%, and continuous follow-ups improved compliance.
Why the study?
Venous thromboembolism is a potentially fatal post-arthroplasty complication, but prophylaxis studies have focused primarily on the in-hospital period rather than extramural hospital management.
Cross-Sectional (n=180)
No
Continuous follow-up and patient education after discharge for total hip or knee arthroplasty improves patient compliance and satisfaction with VTE prophylaxis.
Survey reveals inconsistent post-discharge VTE management after THA/TKA in China; leaves open need for standardized protocols and validation studies.
BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication after arthroplasty. Numerous prophylactic strategies and studies to reduce VTEs have focused on the duration of the hospital stay and on few extramural hospitals. This study aimed to investigate extramural hospital management of VTE after total hip/knee arthroplasty (THA/TKA) in China with a novel survey tool. METHODS: A total of 180 patients undergoing arthroplasty, including 68 THA patients and 112 TKA patients, were enrolled in this study. All patients received anticoagulant treatment management. A survey querying VTE management and adherence, such as therapy information, understanding of anticoagulation, satisfaction with the ability of medical staff, and satisfaction with health care costs, was administered by a questionnaire (TKA/THA Patients' Experience with Anticoagulation in the Post-discharge Period) for quality improvement. RESULTS: The average age of the patients was 65.27 ± 13.62 years. All patients knew their follow-up times. 85 % of them were suggested that re-examine at the next 14 days, and the others at the next 28 days. All patients continued to visit the orthopaedic clinic after discharge without choosing other types of outpatient services, such as an anticoagulant clinic or home visit with a nurse/pharmacist or remote evaluation by telephone. A total of 96.6 % of all patients used new oral anticoagulants, and the most common treatment duration was 2-4 weeks (93.3 %). 48 % informed their physicians that they were taking anticoagulation medications when they visited ophthalmology, dentistry, dermatology, and other departments. The overall rate of satisfaction with anticoagulation management was 81.67 %, and 6.67 % of patients were not unsatisfied with their medical expenses. Patient compliance decreased with increasing follow-up time. Continuous follow-ups after discharge significantly improved patient compliance. CONCLUSIONS: These results elucidate how we can improve the quality of anticoagulation. Continuous follow-up appointments for 30 days after discharge, especially for individuals over 65 years old, significantly improved patient satisfaction and reduced the incidence of VTE and medical costs.
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Tong et al. (2021) conducted a cross-sectional in Venous thromboembolism prophylaxis after total hip and knee arthroplasty (n=180). Post-discharge anticoagulation management was evaluated on Overall satisfaction with anticoagulation management. Among 180 patients undergoing total hip or knee arthroplasty, the overall rate of satisfaction with post-discharge anticoagulation management was 81.67%, and continuous follow-ups improved compliance.
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