[Adherence to and satisfaction with oral outpatient thromboembolism prophylaxis compared to parenteral: SALTO study]. / Adherencia y satisfacción en la profilaxis antitrombótica ambulatoria oral frente a la parenteral: estudio SALTO.

INTRODUCTION: Prolongation of drug-based thromboembolism prophylaxis after discharge from hospital is clearly recommended following total hip and knee replacement. The aim of this study was to evaluate and compare adherence to and satisfaction with outpatient thromboembolism prophylaxis (by injection and oral) under routine clinical practice conditions. MATERIAL AND METHOD: We analysed two consecutive cohorts of patients (480 and 366, respectively) who had undergone total hip or knee replacement surgery in 120 Spanish hospitals, and were prescribed outpatient thromboembolism prophylaxis, by injection and orally, respectively. Information on adherence to and satisfaction with both treatments, sociodemographic data and treatment compliance was collected using specific questionnaires. RESULTS: The drop-out rate (9.49 vs. 4.14%), general satisfaction (37 vs. 83.38%), and the TSQM satisfaction scale were better in the oral prophylaxis cohort and, although the differences between the two routes of administration were not significant, treatment compliance was also better in the oral cohort (Morisky-Green test: 53.49 vs. 59.05%). CONCLUSIONS: Adherence to and satisfaction with the oral thromboembolism prophylaxis were better than for prophylaxis by injection in the context of outpatient prolongation. Nevertheless, suboptimal treatment compliance was found in both cohorts, which could result in lack of efficacy of the prophylaxis. Both patients and doctors have to be made aware of the importance of post-discharge extension of thromboprophylaxis in orthopaedic surgery with high thrombotic risk. Moreover, strategies should be developed to encourage compliance.

Adherencia y satisfacción en la profilaxis antitrombótica ambulatoria oral frente a la parenteral: estudio SALTO / Adherence to and satisfaction with oral outpatient thromboembolism prophylaxis compared to parenteral: SALTO study

Introducción. La profilaxis tromboembólica farmacológica, prolongada tras el alta hospitalaria, está claramente recomendada en el postoperatorio de la artroplastia total de cadera y rodilla. Este estudio pretende valorar y comparar la adherencia y la satisfacción a la profilaxis tromboembólica ambulatoria (inyectable y oral), en condiciones de práctica clínica habitual. Material y método. Se analizan 2 cohortes consecutivas de pacientes (480 y 366 respectivamente) intervenidos de artroplastia total de cadera o rodilla en 120 hospitales españoles, a las que se indica la profilaxis tromboembólica ambulatoria inyectable y oral, respectivamente. Mediante cuestionarios específicos, se recoge información sobre la adherencia y satisfacción a ambos tratamientos, datos sociodemográficos y cumplimiento terapéutico. Resultados. Las tasas de abandono (9,49 vs. 4,14%), la satisfacción general (37 vs. 83,38%) y la escala de satisfacción de TSQM fueron más favorables en la cohorte de la profilaxis oral. El cumplimiento terapéutico, si bien sin diferencias significativas entre ambas pautas (test de Morisky-Green de 53,49 vs. 59,05%), fue también superior en la cohorte de la tromboprofilaxis oral. Conclusiones. La adherencia y la satisfacción a la profilaxis tromboembólica oral son superiores a la profilaxis inyectable en el contexto de la prolongación ambulatoria. Sin embargo, en ambas cohortes se evidencia un subóptimo cumplimiento terapéutico que podría repercutir en una merma en la eficacia de dicha profilaxis. Es preciso concienciar al paciente y a los médicos de la importancia de la extensión ambulatoria de la tromboprofilaxis en la cirugía ortopédica de alto riesgo trombótico, así como desarrollar estrategias que favorezcan su cumplimiento (AU)

Introduction. Prolongation of drug-based thromboembolism prophylaxis after discharge from hospital is clearly recommended following total hip and knee replacement. The aim of this study was to evaluate and compare adherence to and satisfaction with outpatient thromboembolism prophylaxis (by injection and oral) under routine clinical practice conditions. Material and method. We analysed two consecutive cohorts of patients (480 and 366, respectively) who had undergone total hip or knee replacement surgery in 120 Spanish hospitals, and were prescribed outpatient thromboembolism prophylaxis, by injection and orally, respectively. Information on adherence to and satisfaction with both treatments, sociodemographic data and treatment compliance was collected using specific questionnaires. Results. The drop-out rate (9.49 vs. 4.14%), general satisfaction (37 vs. 83.38%), and the TSQM satisfaction scale were better in the oral prophylaxis cohort and, although the differences between the two routes of administration were not significant, treatment compliance was also better in the oral cohort (Morisky-Green test: 53.49 vs. 59.05%). Conclusions. Adherence to and satisfaction with the oral thromboembolism prophylaxis were better than for prophylaxis by injection in the context of outpatient prolongation. Nevertheless, suboptimal treatment compliance was found in both cohorts, which could result in lack of efficacy of the prophylaxis. Both patients and doctors have to be made aware of the importance of post-discharge extension of thromboprophylaxis in orthopaedic surgery with high thrombotic risk. Moreover, strategies should be developed to encourage compliance (AU)