Awareness and Perception of Thromboembolism and Thromboprophylaxis among Hospitalized Patients in Jordan

Abstract

Background and Objective: Despite the established importance of thromboprophylaxis in patients with Venous Thromboembolism (VTE), a limited number of studies have assessed the awareness of VTE and thromboprophylaxis therapy among the affected patients. The aim of the current study was to assess awareness and to explore variables associated with awareness about VTE and its thromboprophylaxis. Methods: A cross-sectional study was conducted on hospitalized patients who received thromboprophylaxis (5000 units of heparin subcutaneously (SC) q8-12h, or 30-40 mg of enoxaparin SC once daily). In addition to the sociodemographic variables, awareness and perception of VTE and its thromboprophylaxis were assessed using a validated questionnaire. Multiple logistic regressions were conducted to build a model of variables significantly associated with VTE awareness. Results: A total of 225 patients participated in the study, with only 38.2% and 22.2% of the participants being aware of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) respectively. Logistic regression showed that the participants with low educational level had 3.046 value, with the odds being not aware of DVT or PE compared with participants with high educational level. Participants without a personal history of VTE had 7.374 value, with the odds being not aware of DVT or PE compared with those who had a personal history of VTE. Participants who had a negative perception of VTE had 2.582 value, with the odds being not aware of DVT or PE compared with participants who had a positive perception and those who did not have any information about DVT or PE had 13.727 value, with the odds being not aware of DVT or PE. Conclusion: The findings reveal that there is a lack of awareness about VTE and its thromboprophylaxis among the study participants. Patients with lower educational level and those with no history of previous VTE need awareness improvement about VTE and its thromboprophylaxis. Clinical Pharmacists need to focus on providing information about VTE and improving patients’ perception about VTE and its thromboprophylaxis with the aim of improving the awareness about VTE, and hence the better health outcome.

Awareness and Perception of Hospitalized Patients on Thromboembolism and Thromboprophylaxis: A Cross-Sectional Study in Sana’a-Yemen

“…This finding shed light on the vital role of health-care providers in educating their patients about the benefits of ambulating during hospitalization. This finding is in agreement with other studies that were conducted in Jordan, 10 Saudi Arabia, 14,21 and Canada. 13 Another study that was conducted to measure global public awareness of nine countries, including the United States, the United Kingdom, the Netherlands, Thailand, Japan, Germany, Canada, Australia, and Argentina, showed that immobility is the most recognized VTE risk factor in these countries.…”

“…This result could be attributed to the fact that Yemeni patients were unaware that PE is considered a complication of DVT. This finding agrees with the study conducted in Jordan by Jarab et al 10 On the other hand in developed countries, a study from Canada by Saga et al found that most hospitalized patients (81.2%) had good knowledge of both DVT and PE. 13 Another study from the United States by Konieczyńska et al reported that younger patients had good knowledge about VTE in general.…”

“…As a result, more health education about VTE in hospitalized patients is crucial to make them active participants in VTE prophylaxis, thus, shifting VTE risk factors downward. In the line with the following studies, 10,13 the finding of this study showed that walking or stretching the legs is the nonpharmacologic strategy to prevent VTE. Generally, insufficient knowledge about VTE is a common international concern, particularly for developing countries such as Yemen.…”

“…Previously validated questionnaires were used with slight modifications on their items. 10,14 A forward translation from English to Arabic was performed. To ensure the validity of the content, the study instrument was reviewed by a multidisciplinary panel of experts: two cardiologists, one community medicine physician, and two holding a master's in Clinical Pharmacy.…”

“…9 Studies have shown that limited patient knowledge may negatively impact patient involvement in VTE treatment and prophylaxis. [10][11][12][13][14] Educating the patient before medication initiation may enhance adherence, especially when the patients appreciate their medication purpose and the consequences of refusing thromboprophylaxis. A case in point, a study by Piazza et al found that a pharmacist-led individualized patient education program was associated with higher medication compliance and reduction in patient refusal.…”