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PM.21 Compliance with Postnatal Thromboprophylaxis
  1. F Ayim2,
  2. DA Banfield1,
  3. JC Girling2,
  4. L Page
  1. 1Imperial College London, London, UK
  2. 2West Middlesex University Hospital, Middlesex, UK

Abstract

Background Venous thromboembolism (VTE) is the 3rd leading cause of maternal death in the UK1. In order to minimise VTE risk in the postnatal period, we introduced a new scoring system in June 2011, based on RCOG guidelines2. Every woman’s VTE risk is scored, and those who meet predetermined criteria are discharged on a seven days (7/7) or six weeks (6/52) course of low molecular weight heparin (LMWH). There were concerns regarding patient compliance and so a survey was conducted to explore this.

Method Pharmacy data identified 113 postnatal women who were discharged in November 2011 on LMWH. A telephone survey in February 2012 assessed understanding of the need for LMWH, and compliance.

Results 52 women were successfully contacted: 29 had been prescribed a 7/7 course, and 23 a 6/52 course.

  • 100% of women understood the need for LMWH.

  • 96% of those on a 7/7 course completed all injections.

  • Only 32% completed the 6/52 course.

We identified reasons for non-compliance and the destination of unused LMWH.

Conclusion Non-compliance has implications for both patient safety and cost. The survey highlighted the importance of effective patient education and identified a need for improved communication between primary and secondary care. A multidisciplinary approach, with all healthcare professionals emphasising the importance of LMWH in the postnatal period may improve long-term compliance. A patient information leaflet has since been introduced.

References

  1. Centre for Maternal and Child Enquiries. Saving Mothers’ Lives: Reviewing Maternal Deaths to Make Motherhood Safer, 2006–2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CMACE March 2011.

  2. Royal College of Obstetricians and Gynaecologists. Green top Guideline No.37a: Reducing the risk of Thrombosis and Embolism during Pregnancy and the Puerperium. November 2009.

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