Enoxaparin adherence for venous thromboembolism prophylaxis in hospitalized patients with sickle cell disease

ABSTRACT

Background

Venous thromboembolism (VTE) is a common cause of morbidity and mortality in patients with sickle cell disease (SCD).

Methods

This retrospective study assessed adherence to prescribed enoxaparin for VTE prophylaxis in adults with SCD while hospitalized. A total of 172 encounters of 72 unique patients were evaluated between 1 January and 31 December 2019. Patients were grouped based on adherence to prescribed enoxaparin. Group 1 received 100% of doses ordered. Group 2 received between 99% and 1% of doses ordered. Group 3 received 0% of doses ordered.

Results

Only 45 encounters (32.3%) received 100% of ordered doses and 81 encounters (47%) did not receive any of the ordered enoxaparin doses. In total, only 37% of all prescribed enoxaparin doses were administered to patients.

Conclusion

This low level of administered enoxaparin is concerning in a patient population at an increased risk for VTE. VTE prophylaxis adherence needs to be addressed with each admission and, if appropriate, alterative options to enoxaparin should be considered.

KEYWORDS:

• Venous thromboembolism
• prophylaxis
• sickle cell disease
• enoxaparin
• adherence

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A peer reviewer on this manuscript has received support for work in the prevention of venous thromboembolism through grants from the Agency for Healthcare Research and Quality (AHRQ), the Patient Centered Outcomes Research Institute (PCORI), the National Institutes of Health/National Heart Lung and Blood Institute (NIH/NHLBI), and the US Department of Defense.

Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.