Model of quality of timely attention to the patient with cancer

Abstract

Aims: Recent guidelines have recommended the routine prescription of extended thromboprophylaxis following all major abdominal cancer surgery. For the majority of patients this will involve receiving injections of low molecular weight heparin (LMWH) after discharge. Most commonly this is achieved with patients or their relatives trained to selfadminister injections of LMWH. Whilst there is significant data proving the safety of extended prophylaxis, there is very little data regarding compliance with LMWH administration following major hepatobiliary resection. The aim of this study is to assess patient compliance with extended prophylaxis as well as satisfaction with the process. Methods: Patient notes were retrospectively reviewed over a 6 week period. All patients discharged with a prescription for extended VTE prophylaxis were included. Patients were contacted via telephone and interviewed with a standardised questionnaire to assess compliance and satisfaction with administration of LMWH in the home setting. Results: A total of 10 patients were identified. One patient was excluded as they were not contactable. All of the remaining 9 stated that they successfully completed the 28 day course, with no patient recalling any missed doses. LMWH was self administered in 6 patients with the remaining three administered by a relative. Seven patients felt entirely satisfied with the process with two feeling there was scope for improvement in the education and demonstration of the administration of the LMWH. Conclusions: Self-administered extended VTE prophylaxis is not only safe, but is also well tolerated. Proper patient education is key to ensuring satisfaction with the process.