Enoxaparin for thromboprophylaxis in overweight and obese patients: a prescribing audit at a tertiary hospital

Abstract

Obesity increases the risk of venous thromboembolism (VTE). Literature is inconclusive regarding fixed or weight‐based dose adjustment of enoxaparin to prevent VTE in overweight and obese patients. Data were collected for all adult patients who received enoxaparin in one of three wards at Royal Perth Hospital from September to December 2016. The reference dose for non‐obese patients was 40 mg daily. The key outcome was the percentage of obese patients (body mass index (BMI) ≥ 30 kg/m2) receiving dose‐adjusted enoxaparin. Of the 343 patients who received enoxaparin, 92 (27%) were obese and 108 (32%) overweight. Of 141 patients of ?normal’ BMI, 127 (90%) received appropriate doses. Two obese patients received adjusted enoxaparin doses: 60 mg daily for 6 days, and 40 mg twice daily before titration. Weight‐based enoxaparin dosing was not prevalent in this sample of 92 obese patients. Local prescribing guidelines are warranted, and their effect should be monitored.