Aspirin: are patients actually taking it?—A quality assessment study

• Main Authors: Steven Lewis, MD, Shaun Kink, MD, Michael Rahl, MS, Ashley Nord, MS, Jason Meldau, MD, Karl Roberts, MD
• Format: Article
• Language: English
• Published: Elsevier 2018-12-01
• Series: Arthroplasty Today
• Online Access: http://www.sciencedirect.com/science/article/pii/S235234411830075X

Background: The purpose of the study was to assess patient adherence to an aspirin-based prophylactic deep venous thromboembolism (DVT) care management plan after total lower extremity arthroplasty. Methods: Using a cross-sectional study design, patients who underwent total hip or knee replacement surgery by a single senior surgeon were surveyed at their routine 6-week follow-up appointment regarding adherence to aspirin DVT prophylaxis. Postoperatively, patients were advised to take 325 mg of aspirin twice daily for 6 weeks to prevent DVT. Results: Of the 101 patients surveyed, 45 underwent total hip arthroplasty while 56 underwent total knee arthroplasty. There were 48 (48%) patients who were still taking aspirin at their routine 6-week postoperative follow-up appointment and 53 (52%) patients who were not taking aspirin (nonadherent group). Of the latter, 3 (6%) never took aspirin postoperatively, 14 (26%) discontinued within 2 weeks postoperatively, and 23 (43%) did not take it any longer for half the time prescribed. In the nonadherent group, 8 patients reported that they felt they did not need the aspirin prophylaxis, 5 experienced side effects, and 10 were unsure of how long they needed to take it. There was 1 patient with a calf DVT and no episodes of pulmonary embolism. Conclusions: Over half of our study, patients did not finish their aspirin regimen. We suggest a consistent outline of medication duration throughout the pre/postop course and communication regarding aspirin cessation. Keywords: Aspirin, DVT prophylaxis adherence, Primary total joint arthroplasty, DVT, Patient education