Intermittent pneumatic compression for venous thromboembolism prevention: a systematic review on factors affecting adherence.

OBJECTIVE: Venous thromboembolism (VTE) is a potentially fatal complication of hospitalisation. Intermittent pneumatic compression (IPC) is one approach to reducing the likelihood of a VTE. Adherence to IPC is known to be inadequate though the reasons for this remain unclear. This systematic review explores factors that affect adherence to IPC in the inpatient context. METHODS: Information sources-EMBASE, MEDLINE and PsycINFO were searched for literature between January 1960 and May 2019. Eligibility criteria-studies were included if they focused on inpatient care and examined factors affecting adherence to IPC devices. RESULTS: Included studies-a total of 20 out of 1476 studies were included. Synthesis of results-eight factors were identified that affected adherence: patient discomfort (n=8), healthcare professionals' knowledge and behaviours (n=6), mobilisation (n=6), equipment supply and demand (n=3), the use of guidelines (n=3), intensive care context (n=2), computer-assisted prescribing (n=2) and patients' knowledge of IPC (n=1). CONCLUSION: Overall while the evidence base is quite limited, a number of factors were shown to affect adherence to IPC. These findings could be used to inform future research and quality improvement efforts to increase adherence in this very important, but currently under-researched area.

Prevention, diagnosis and treatment of venous thromboembolism.

Venous thromboembolism (VTE) occurs more frequently in older people. For those nursing older people in a variety of settings, knowledge of VTE prevention, diagnosis and treatment is essential. This article discusses simple, practical measures that can be used to reduce the risk of VTE, including good hydration and promotion of mobilisation. It also discusses how a VTE forms, the signs and symptoms, and the methods used to diagnose and treat VTE. In recent years new drugs have been licensed to treat patients with VTE called direct oral anticoagulants. This article explores recent evidence and important considerations for their use in treatment of VTE.