Research Article
Appropriateness of Pharmacologic Prophylaxis
against Deep Vein Thrombosis in Medical Wards of an
Ethiopian Referral Hospital
Mohammed Biset Ayalew ,
1
Boressa Adugna Horsa ,
1
and Meseret Tilahun Zeleke
2
1
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
2
Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
Correspondence should be addressed to Mohammed Biset Ayalew; mb6767@gmail.com
Received 23 March 2018; Accepted 27 June 2018; Published 11 July 2018
Academic Editor: John A. Kern
Copyright © 2018 Mohammed Biset Ayalew et al. Tisis an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Most of hospitalized patents are at risk of developing deep vein thrombosis (DVT). Te use of pharmacological
prophylaxis signifcantly reduces the incidence of thromboembolic events in high risk patients. Te aim of this study was to assess
appropriateness of DVT prophylaxis in hospitalized medical patients in an Ethiopian referral hospital. Methods. Cross-sectional
study design was employed. Patients with a diagnosis of DVT, taking anticoagulant therapy, and those who refused to participate
were excluded from the study. Two hundred and six patients were included in the study using simple random sampling method.
Modifed Padua Risk Assessment Model was used to determine the risk of thromboembolism. SPSS (version 21) was used for
analysis. Result. Te total risk score for the study subjects ranged from 0 to 11 with a mean score of 3.41 ± 2.55. Nearly half (47.6%)
of study participants had high risk to develop thromboembolism. Trombocytopenia (platelets < 50 billion/L) or coagulopathy,
active hemorrhage, and end stage liver disease (INR > 1.5) were the frequently observed absolute contraindications that potentially
prevent patients from receiving thromboprophylaxis. Tromboprophylaxis use in nearly one-third (31.6%) of patients admitted in
the medical ward of UoGRH was irrational. Patients who had high risk for thromboembolism are more likely to be inappropriately
managed for their risk of thromboembolism and patients with thrombocytopenia or coagulopathy were more likely to be managed
appropriately. Conclusion. Tere is underutilization of pharmacologic thromboprophylaxis in medical ward patients. Physicians
working there should be aware of risk factors for DVT and indications for pharmacologic thromboprophylaxis and should adhere
to guideline recommendations.
1. Introduction
Deep vein thrombosis (DVT) is a condition that occurs
due to clotting of blood in veins located deep inside the
body, mostly in the thigh and lower leg. It is also known as
thromboembolism, postphlebitis syndrome, or postthrom-
botic syndrome [1]. DVT occurs in association with many
common medical and surgical conditions. It is also the major
cause of morbidity and mortality in hospitalized patients.
Approximately 600,000 hospital admissions are related to
DVT, and of these patients, 50,000 to 200,000 will develop
pulmonary embolism [2].
Many factors are known to increase the risk of venous
thromboembolism (VTE). Among these the main ones
are hospitalization, hypercoagulable disorders, cancer, and
surgery [1]. Tere are 2 types of DVT prevention methods
for patients who are at risk of developing it. Te frst
is nonpharmacologic prophylaxis like the use of compres-
sion stockings, leg elevation, sequential compression devices
(SCDs), ambulation, and vena cava flter and the second is
“pharmacologic,” which is through the use of blood thinning
medications [1, 3]. Te most common blood thinner used
as DVT prophylaxis in Ethiopia is unfractionated heparin
(UFH). Te other well-known blood thinner, Warfarin, is not
used as a primary prevention of VTE in patients who had no
previous VTE; rather its use is established in the prevention
of recurrent VTE in patients who already had it.
Te major side efect from blood thinning medications
is an increased risk of bleeding [1]. Some patients are con-
traindicated for blood thinning medications since they have
Hindawi
International Journal of Vascular Medicine
Volume 2018, Article ID 8176898, 7 pages
https://doi.org/10.1155/2018/8176898