Postpartum thromboprophylaxis with enoxaparin: a prospective cohort study on patients' adherence, injection experience, and information retention after counselling by pharmacists.

IF 1.5 Q3 PHARMACOLOGY & PHARMACY
Boon Phiaw Kho, Hui Ting Ho, Shi Ying Tan, Fei San Chee, Fen Ting Kow, Silvia Ooi, Ying Min Kan
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Abstract

Objectives: This research aimed to determine postpartum females' self-reported adherence to and experience with short-term thromboprophylaxis using enoxaparin injection, after counselling by pharmacists. It also sought to assess their knowledge of thromboprophylaxis, injection techniques, and confidence in self-injecting.

Methods: This prospective cohort study was conducted at a public tertiary hospital in Malaysia from March to June 2023. Self-injection-naïve postpartum females who were initiated on thromboprophylaxis and counselled by a pharmacist were conveniently sampled. Knowledge regarding thromboprophylaxis, injection readiness, and technique were assessed one day after the counselling session. A telephonic interview was conducted at the end of the 10-day therapy to determine adherence and adverse effects experienced.

Key findings: A total of 259 subjects were successfully followed up, with 87.6% (n = 227) adherent to the therapy. Nonadherence was predominantly due to forgetfulness; four had their treatment withheld due to bleeding. One-third of subjects experienced localised pain and bruising. Subjects answered a median of 5/7 knowledge questions and recalled a median of 8/10 injection steps correctly, with those who read the information leaflet provided after counselling scoring significantly higher (P = .02). The majority declared moderate confidence in their ability to self-inject. Subjects who intended to self-inject (P < .01) and were more confident (P = .02) demonstrated better injection technique.

Conclusions: Postpartum females counselled by pharmacists largely adhered to short-term enoxaparin for thromboprophylaxis. The impact of the counselling session may be enhanced by addressing their psychological readiness to self-inject, awareness of adverse effects identification, mitigation, and management, as well as setting reminders to prevent forgetfulness to inject.

使用依诺肝素进行产后血栓预防:关于药剂师指导后患者依从性、注射体验和信息保留的前瞻性队列研究。
研究目的本研究旨在了解产后女性在接受药剂师咨询后,对使用依诺肝素注射液进行短期血栓预防的自述依从性和经验。研究还试图评估她们对血栓预防知识、注射技术以及自我注射的信心:这项前瞻性队列研究于 2023 年 3 月至 6 月在马来西亚一家公立三级医院进行。研究方便地抽取了初次接受血栓预防并在药剂师指导下进行自我注射的产后女性。咨询结束一天后,对血栓预防知识、注射准备情况和技术进行了评估。在为期 10 天的治疗结束后进行了电话访谈,以确定受试者的依从性和不良反应:共有 259 名受试者成功接受了随访,其中 87.6%(n = 227)的受试者坚持了治疗。不坚持治疗的主要原因是健忘;有四人因出血而暂停治疗。三分之一的受试者出现局部疼痛和瘀伤。受试者回答知识问题的中位数为 5/7,正确回忆注射步骤的中位数为 8/10,其中阅读了咨询后提供的信息宣传单的受试者得分明显更高(P = .02)。大多数受试者表示对自己的自我注射能力有一定信心。打算自行注射的受试者(P < .01)和更有信心的受试者(P = .02)表现出了更好的注射技巧:结论:接受过药剂师指导的产后女性大多坚持使用短期依诺肝素进行血栓预防。通过解决她们自我注射的心理准备、对不良反应的识别、缓解和处理的认识以及设置提醒以防止忘记注射等问题,可以增强辅导课的效果。
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来源期刊
CiteScore
2.90
自引率
5.60%
发文量
146
期刊介绍: The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
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