Maxwell GL, Synan I, Hayes RP, Clarke-Pearson DL.
Preference and compliance in postoperative thromboembolism prophylaxis among
gynecologic oncology patients.
Obstet Gynecol 2002 Sep;100(3):451-5

Division of Gynecologic Oncology, Duke University Medical Center, Durham, North
Carolina 27710, USA.

OBJECTIVE: To compare low molecular weight heparin and external pneumatic
compression in terms of patient preference and compliance to determine if either
of these two methods is superior in postoperative thromboembolism prophylaxis of
gynecologic oncology patients. METHODS: A total of 211 patients undergoing major
surgery for a suspected gynecologic malignancy were randomized to receive
thromboembolism prophylaxis with either external pneumatic compression or low
molecular weight heparin. Surveys regarding thromboembolism prophylaxis were
completed by patients before surgery and approximately 7 days postoperatively.
Patient preferences as well as reasons for patient dissatisfaction with
prophylactic methods were elicited in the questionnaires. In addition, patient
compliance with prophylaxis was recorded twice a day during hospitalization.
Patients were not considered to be compliant with prophylaxis if the external
pneumatic compression device was not functioning properly or if the
administration of low molecular weight heparin was not given in a timely manner.
RESULTS: The majority of patients were satisfied with the prophylactic method
that they received to the extent that they would prefer the treatment they
received to one they had not necessarily experienced. The postoperative
preferences of 78% of patients receiving low molecular weight heparin and 74% of
those wearing external pneumatic compression corresponded to what the patients
actually received as a method of thromboembolism prevention. Patient compliance
with prophylaxis was noted to be inadequate in ten of 104 (9.6%) patients
receiving external pneumatic compression and seven of 103 (6.8%) patients
receiving low molecular weight heparin. CONCLUSION: Pneumatic compression and low
molecular weight heparin are similar both in terms of patient preference and
compliance among gynecologic oncology patients receiving postoperative
thromboembolism prophylaxis.