Adesão à profilaxia farmacológica de tromboembolismo venoso por pacientes submetidos a cirurgias ortopédicas

Abstract

Venous thromboembolism (VTE) is a phenomenon caused by the formation of thrombus related to venous stasis, endothelial lesion and hypercoagulability. Orthopedic surgeries, especially knee and hip arthroplasties, are risk factors for the occurrence of VTE with the recommendation of extended postoperative pharmacological prophylaxis. This study aimed to identify the adherence profile to the pharmacological prophylaxis of VTE in patients submitted to knee or hip arthroplasty, from August 2017 to September 2018, at the University Hospital of the Federal University of Maranhão UHFUMA, São Luís. A descriptive-observational cross-sectional study was conducted with adult patients who underwent pharmacotherapeutic follow-up at the hospital and in the postoperative period during outpatient return visits. To measure adhesion the Morisky Medication Adherence Scale (MMAS 8) was applied. Were related factors related to self-perception, social and economic, clinical condition and pharmacotherapy of the patients with thromboprophylaxis adherence. The results presented correspond to the follow-up of 70 patients characterized predominantly by the female sex, age over 60 years, with up to 4 years of study and income of 2 to 3 minimum wages. Clinical data show that the majority need to perform hip arthroplasty surgery (85.7%), had some chronic disease (65.7%) and were polymedicated (70.0%). The anticoagulant prescribed at hospital discharge was rivaroxaban. A percentage of 82.9% showed knowledge about the purpose of the anticoagulant and almost 93.0% knew the way to use it, with good and excellent acceptance of prophylaxis. Adherence analysis by the Morisky Medication Adherence Scale showed that in 73.0% of the patients adherence, while 27.0% were not adherent to thromboprophylaxis. Had mayor adherence that patients who did not need guidance during follow-up, they reported good and excellent acceptance prophylaxis, although polymedicated during discharge. The data obtained allowed us to conclude that there was a limiting factor for complete drug adherence to VTE prophylaxis, performed with rivaroxaban, in patients with low socioeconomic conditions, who underwent hip or knee arthroplasty.