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Rates of elastic compression stockings prescription following the diagnosis of deep venous thrombosis among Canadian emergency physicians and trainees

  • Ahmed Kayssi (a1), Andrew Petrosoniak (a2), Jeremy Levenstadt (a3), Naomi Eisenberg (a1), Sue Jenkins (a4) and Graham Roche-Nagle (a1)...

Abstract

Introduction

Postthrombotic syndrome (PTS) is a complication of deep vein thrombosis (DVT) characterized by chronic pain, swelling, and heaviness, and may result in ulceration. Elastic compression stockings (ECS) worn daily after DVT have been shown to reduce the incidence and severity of PTS. The aim of our study was to investigate practices and perceptions of physicians regarding adjunct therapies to anticoagulation in patients diagnosed with lower extremity DVT.

Methods

A national online survey was conducted of Canadian emergency medicine staff physicians and residents (n=471) to investigate their attitudes toward the prescription of ECS post-diagnosis of DVT. A paper survey of patients in a thrombosis clinic (n=58) was also administered to better understand the patient experiences with ECS.

Results

The majority of staff physician (62%) and resident (69%) respondents were unsure of whether ECS were effective in preventing PTS and managing venous symptoms. Only 6% of staff physicians and 7% of residents routinely prescribed ECS for above-knee DVTs. More than 78% of respondents were unsure about the optimal timing of initiation of ECS and duration of therapy. Although all patients noted symptomatic relief with ECS, only 50% were prescribed stockings by an emergency or family doctor, and 69% of those patients wore the stockings on a daily basis. Staff physicians most frequently identified poor fit as the reason for lack of patient compliance, whereas patients most frequently cited cost.

Conclusions

Our findings suggest that there is variability in practice among Canadian emergency medicine physicians and trainees and a need for widespread education regarding the latest evidence of the benefit of ECS after DVT.

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Copyright

Corresponding author

Correspondence to: Dr. Graham Roche-Nagle, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4; Email: graham.roche-nagle@uhn.ca

References

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1. Ashrani, AA, Heit, JA. Incidence and cost burden of post-thrombotic syndrome. J Thromb Thrombolysis 2009;28(4):465-476.
2. de Wolf, MA, Wittens, CH, Kahn, SR. Incidence and risk factors of the post-thrombotic syndrome. Phlebology 2012;27(Suppl 1):85-94.
3. Heit, JA, Rooke, TW, Silverstein, MD, et al. Trends in the incidence of venous stasis syndrome and venous ulcer: a 25-year population-based study. J Vasc Surg 2001;33(5):1022-1027.
4. Kahn, SR, Hirsch, A, Shrier, I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med 2002;162(10):1144-1148.
5. Vazquez, SR, Kahn, SR. Advances in the diagnosis and management of postthrombotic syndrome. Best Pract Res Clin Haematol 2012;25(3):391-402.
6. Kolbach, DN, Sandbrink, MW, Hamulyak, K, et al. Non-pharmaceutical measures for prevention of post-thrombotic syndrome. Cochrane Database Syst Rev 2004;1:CD004174.
7. Snow, V, Qaseem, A, Barry, P, et al. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Fam Med 2007;5(1):74-80.
8. Kearon, C, Akl, EA, Comerota, AJ, et al. Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141(2 Suppl):e419S-e494S.
9. Blattler, W, Gerlach, HE. Implementation of outpatient treatment of deep-vein thrombosis in private practices in Germany. Eur J Vasc Endovasc Surg 2005;30(3):319-324.
10. Kahn, SR, Elman, E, Rodger, MA, et al. Use of elastic compression stockings after deep venous thrombosis: a comparison of practices and perceptions of thrombosis physicians and patients. J Thromb Haemost 2003;1(3):500-506.
11. Roche-Nagle, G, Ward, F, Barry, M. Current prescribing patterns of elastic compression stockings post-deep venous thrombosis. Phlebology 2010;25(2):72-78.
12. Dillman, DA. Mail and Internet Surveys: the Tailored Design Method. New York: John Wiley and Sons, 2000.
13. StataCorp. Stata Statistical Software: Release 12. College Station, Texas: StataCorp LP, 2011.
14. Microsoft. 2003. Microsoft Excel 2010. Redmond, Washington: Microsoft.
15. Partsch, H, Blattler, W. Compression and walking versus bed rest in the treatment of proximal deep venous thrombosis with low molecular weight heparin. J Vasc Surg 2000;32(5):861-869.
16. Hohl, CM, Abu-Laban, RB, Brubacher, JR, et al. Adherence to emergency department discharge prescriptions. CJEM 2009;11(2):131-138.
17. Suffoletto, B, Calabria, J, Ross, A, et al. A mobile phone text message program to measure oral antibiotic use and provide feedback on adherence to patients discharged from the emergency department. Acad Emerg Med 2012;19(8):949-958.
18. Asch, DA, Jedrziewski, MK, Christakis, NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997;50(10):1129-1136.
19. Cummings, SM, Savitz, LA, Konrad, TR. Reported response rates to mailed physician questionnaires. Health Serv Res 2001;35(6):1347-1355.
20. Grava-Gubins, I, Scott, S. Effects of various methodologic strategies: survey response rates among Canadian physicians and physicians-in-training. Can Fam Physician 2008;54(10):1424-1430.

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Rates of elastic compression stockings prescription following the diagnosis of deep venous thrombosis among Canadian emergency physicians and trainees

  • Ahmed Kayssi (a1), Andrew Petrosoniak (a2), Jeremy Levenstadt (a3), Naomi Eisenberg (a1), Sue Jenkins (a4) and Graham Roche-Nagle (a1)...

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