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Women's views and adherence to low molecular weight heparin therapy during pregnancy and the puerperium.
MedLine Citation:
PMID:  23039905     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Non adherence to prescribed medication represents a significant factor associated with treatment failure. Pregnant women identified at risk of venous thromboembolism are increasingly being prescribed low molecular weight heparin (LMWH) during pregnancy and the puerperium. It is important to understand women's views and adherence to LMWH during pregnancy and the puerperium, so that women gain maximum benefit from the treatment. Objectives: To monitor women's adherence to enoxaparin, when prescribed during pregnancy and the puerperium and explore their beliefs about the enoxaparin therapy prescribed. Patients/Methods: A prospective cohort study involving ninety-five nullparous and multiparous women prescribed enoxaparin for recognised antenatal indications. Adherence to enoxaparin was assessed through self completion of a diary, additionally verified through laboratory tests. An adapted beliefs about medication questionnaire was administered to women during their pregnancy. Results: Women were highly adherent to enoxaparin; antenatally, mean percentage adherence 97.92%, postnatally mean percentage adherence 93.37% (paired t-test, p=0.000). In the cohort we followed, their perceived necessity for enoxaparin therapy outweighed any concerns they had regarding enoxaparin antenatally, necessity-concerns differential 2.20, however in some women this perceived necessity does decrease postnatally. Conclusions: Our results suggest that most women prescribed enoxaparin are highly adherent to their therapy during the antenatal period and that women's antenatal beliefs about enoxaparin are able to predict a decrease in postnatal adherence. Our results have important clinical implications, particularly when women are initiated on LMWH just during the post-natal period. © 2012 International Society on Thrombosis and Haemostasis.
Authors:
Jp Patel; V Auyeung; Rk Patel; Ms Marsh; B Green; R Arya; Jg Davies
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-5
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 International Society on Thrombosis and Haemostasis.
Affiliation:
King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital Foundation NHS Trust, UK Institute of Pharmaceutical Science, King's College London, UK Department of Obstetrics and Gynaecology, King's College Hospital Foundation NHS Trust, UK Model Answers Pty Ltd, Australia.
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