Assessment of enoxaparin-related knowledge, administration technique, and self-reported adherence among women after caesarean section delivery

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research Pub Date : 2024-10-25 DOI:10.1002/jppr.1943

Sutha Rajakumar BPharm, Retha Rajah PhD, Nur Alia Razali BPharm, Tan Xin Yan BPharm, Ooi Guat Tee BPharm

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Abstract

Background

Venous thromboembolism is among the main causes of maternal morbidity and mortality, with caesarean section (CS) delivery carrying greater risk. Outpatient thromboprophylaxis, such as enoxaparin, is administered subcutaneously and prescribed as an outpatient; raising the issue of medication adherence.

Aim

This study aimed to evaluate women's adherence to enoxaparin administration after CS delivery, explore the reasons for non-adherence, and assess the factors associated with patients' adherence to enoxaparin.

Method

Women after CS delivery, who had been given enoxaparin at discharge were included in the study. Eligible patients were contacted via telephone at the middle and the end of the enoxaparin treatment. Syringe count determined the main outcome of adherence during direct telephone interviews with the patient. Optimal adherence was defined as all the doses of enoxaparin being administered and suboptimal adherence was at least one dose not administered. Ethical approval was granted by the Malaysian Registry Ethics Committee belonging to National Medical Research Registry (Reference no: NMRR ID-22-02859-P41) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants through completion of written consent forms, after an explanation of the study was provided by investigators.

Results

Out of 201 women included, the majority (91.5%) were fully adherent to enoxaparin, while 8.5% missed at least one dose. Most patients administering at home missed the dose due to reporting they were unwell (n = 6), busy (n = 4), or forgot to administer (n = 2). Among missed doses in patients administered in a healthcare setting, all participants (n = 5) forgot to bring their medication to the appointment. Only medication knowledge had a significant association with adherence to enoxaparin administration (p = 0.008).

Conclusion

The study raised concern about the substantial percentage of patients missing at least one dose of enoxaparin, particularly among patients injecting at home. Initiatives should focus on customised enoxaparin administration counselling and providing educational materials.

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评估剖宫产后妇女依诺肝素相关知识、给药技术和自我报告依从性

背景：静脉血栓栓塞是孕产妇发病和死亡的主要原因之一，剖腹产（CS）分娩风险更大。门诊血栓预防，如依诺肝素，是皮下给药和门诊处方；提出了药物依从性的问题。目的本研究旨在评价CS分娩后妇女对依诺肝素的依从性，探讨不依从性的原因，并评估患者对依诺肝素依从性的相关因素。方法：选取CS分娩后出院时给予依诺肝素治疗的产妇为研究对象。在依诺肝素治疗中期和结束时通过电话联系符合条件的患者。在与患者的直接电话访谈中，注射器数量决定了依从性的主要结果。最佳依从性定义为给予所有剂量的依诺肝素，次优依从性是至少不给予一个剂量。属于国家医学研究登记处的马来西亚登记处伦理委员会（参考编号：NMRR ID-22-02859-P41）批准了伦理批准，该研究符合赫尔辛基宣言。在研究者对研究进行解释后，通过填写书面同意书获得所有参与者的知情同意。结果在纳入的201名妇女中，大多数（91.5%）完全坚持使用依诺肝素，而8.5%的妇女至少错过了一次剂量。大多数在家给药的患者由于报告自己身体不适（n = 6）、忙碌（n = 4）或忘记给药（n = 2）而错过给药。在医疗保健机构给药的患者中，所有参与者（n = 5）都忘记将药物带到预约地点。只有药物知识与依诺肝素给药依从性有显著相关性（p = 0.008）。该研究引起了人们对大量患者缺少至少一剂依诺肝素的关注，特别是在家中注射的患者中。倡议应侧重于定制依诺肝素给药咨询和提供教育材料。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pharmacy Practice and Research Health Professions-Pharmacy

CiteScore

1.60

自引率

9.50%

发文量

期刊介绍： The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.