Contributions
Abstract: PB2227
Type: Publication Only
Background
In the absence of anticoagulation therapy, the risk of Venous thromboembolism; deep-vein thrombosis (DVT) and pulmonary embolism(PE)in medically ill patients is comparable to that in moderate-risk surgical patients. Previous studies have revealed grossly inadequate knowledge and a dismal practice of anticoagulation among healthcare workers in some resource poor countries. Prophylactic anticoagulation is under-prescribed in Nigeria, South Africa, as well as in many other countries in Africa.
Aims
The aims of the study are to evaluate the practice of anticoagulant therapy. It will also document the frequency of drug-induced complications resulting from the use of anticoagulants and presence of an anticoagulation policy in the hospitals surveyed.
Methods
Results
A total of 528 clinicians were involved in the survey. There were more males 378 (71.6% ) than females, 150 (28.4%) the clinicians who practiced for less than 5years are in the majority 189 (35.8% ) and those with 15-20 years of practice 46(8.7%) are in the minority. Only 52 of the respondents (9.8%) claimed their institutions had an anticoagulation policy while 274 (51.9% ) of them said there was no such policy and 168 (31.2% ) do not know of any policy. Unfractionated heparin was the most frequently used (96.8%) and fondaparinux was the most infrequently used (42%). Most of the prescriptions were done by younger clinicians who are the highest in number. The consultants prescribed heparin and warfarin most, with the newer anticoagulants taking the rear position. Only 193 (36.6%) of the respondents routinely prescribed anticoagulation therapy when indicated. 412(78%) of respondents believe the risk of anticoagulation outweighs the benefits while 439 (83.1 %) identified cost is an important variable in prescribing anticoagulation agent. Anti-coagulation prophylaxis was the most frequently used for patients immobilized or bedridden (94.1%); malignancy and atrial fibrillation were the most infrequent reasons for using anticoagulation agents (50.6%) . A total of 63 respondents (11.9%) were not satisfied and 219 (41.5%) were not very satisfied with the laboratory monitoring tool available in their institutions. Bleeding is the most common complication of anticoagulation while the least encountered complications are skin and jaw necrosis among the respondents 492(93.2%), 1(0.2%) respectively
Conclusion
This survey has shown the lack of anticoagulation policies among the centers that participated. Our survey has also shown deficiencies in the areas of practice of anticoagulation among the clinicians in the Southeast of Nigeria. These gaps can be remedied by continuous medical education and by the establishment of anticoagulation policies.
Session topic: 34. Thrombosis and vascular biology
Keyword(s): Medical patients, Anticoagulation, Venous thromboembolism
Abstract: PB2227
Type: Publication Only
Background
In the absence of anticoagulation therapy, the risk of Venous thromboembolism; deep-vein thrombosis (DVT) and pulmonary embolism(PE)in medically ill patients is comparable to that in moderate-risk surgical patients. Previous studies have revealed grossly inadequate knowledge and a dismal practice of anticoagulation among healthcare workers in some resource poor countries. Prophylactic anticoagulation is under-prescribed in Nigeria, South Africa, as well as in many other countries in Africa.
Aims
The aims of the study are to evaluate the practice of anticoagulant therapy. It will also document the frequency of drug-induced complications resulting from the use of anticoagulants and presence of an anticoagulation policy in the hospitals surveyed.
Methods
Results
A total of 528 clinicians were involved in the survey. There were more males 378 (71.6% ) than females, 150 (28.4%) the clinicians who practiced for less than 5years are in the majority 189 (35.8% ) and those with 15-20 years of practice 46(8.7%) are in the minority. Only 52 of the respondents (9.8%) claimed their institutions had an anticoagulation policy while 274 (51.9% ) of them said there was no such policy and 168 (31.2% ) do not know of any policy. Unfractionated heparin was the most frequently used (96.8%) and fondaparinux was the most infrequently used (42%). Most of the prescriptions were done by younger clinicians who are the highest in number. The consultants prescribed heparin and warfarin most, with the newer anticoagulants taking the rear position. Only 193 (36.6%) of the respondents routinely prescribed anticoagulation therapy when indicated. 412(78%) of respondents believe the risk of anticoagulation outweighs the benefits while 439 (83.1 %) identified cost is an important variable in prescribing anticoagulation agent. Anti-coagulation prophylaxis was the most frequently used for patients immobilized or bedridden (94.1%); malignancy and atrial fibrillation were the most infrequent reasons for using anticoagulation agents (50.6%) . A total of 63 respondents (11.9%) were not satisfied and 219 (41.5%) were not very satisfied with the laboratory monitoring tool available in their institutions. Bleeding is the most common complication of anticoagulation while the least encountered complications are skin and jaw necrosis among the respondents 492(93.2%), 1(0.2%) respectively
Conclusion
This survey has shown the lack of anticoagulation policies among the centers that participated. Our survey has also shown deficiencies in the areas of practice of anticoagulation among the clinicians in the Southeast of Nigeria. These gaps can be remedied by continuous medical education and by the establishment of anticoagulation policies.
Session topic: 34. Thrombosis and vascular biology
Keyword(s): Medical patients, Anticoagulation, Venous thromboembolism