Abstract

Objectives: The objective of current research was to identify the compliance of antithrombotic drug (heparin, warfarin and Rivaroxaban) and factors of non-compliance associated with heparin, warfarin and rivaroxaban.
 Methodology: A cross-sectional, observational study was conducted on patients suffering from Deep Vein Thrombosis (DVT) at government teaching hospital of Larkana. 348 DVT patients were selected by using online sample calculator software. Data was collected by using pre validated questionnaire after taking patient consent; finally the data was analyzed with statistical package of social sciences (SPSS) version 25.
 Results: The compliance with rivaroxaban was present in 103 (80.5%) patients followed by heparin drug compliance in 95 (74.2%) DVT patients and warfarin drug compliance in 98 (76.6%) DVT patients. Non-compliance factors with rivaroxaban were; cost in 4 (16.0%) patients, polypharmacy in 6 (24.0%) patients, side effects in 4 (16.0%) patients and prolong therapy in 11 (44.0%) patients. Non-compliance factors with heparin were; monitoring in 13 (39.4%) patients, diet restriction in 6 (18.2%) patients, injectable in 10 (30.3%) patients and ADR in 4 (12.1%) patients. Non-compliance factors with warfarin were; cost in 4 (13.3%) patients, polypharmacy in 8 (26.7%) patients, prolong therapy in 5 (16.7%) patients and ADR in 13 (43.3%) patients. 
 Conclusion: This study concludes that rate of drug compliance was high in patients of DVT with rivaroxaban followed by warfarin and heparin, whereas long duration of therapy, polypharmacy, side effects of therapy, cost of therapy, continuous monitoring, injectables, diet restrictions and ADRs of therapy were the most commonly reported factors of non-compliance.

Highlights

  • Deep vein thrombosis (DVT) is defined as “Presence of a blood clot in deep vein of legs or rarely in arms” [1]

  • The compliance with rivaroxaban was present in 103 (80.5%) patients followed by heparin drug compliance in 95 (74.2%) DVT patients and warfarin drug compliance in 98 (76.6%) DVT patients

  • This study concludes that rate of drug compliance was high in patients of DVT with rivaroxaban followed by warfarin and heparin, whereas long duration of therapy, polypharmacy, side effects of therapy, cost of therapy, continuous monitoring, injectables, diet restrictions and ADRs of therapy were the most commonly reported factors of non-compliance

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Summary

Introduction

Deep vein thrombosis (DVT) is defined as “Presence of a blood clot (commonly known as thrombus) in deep vein of legs or rarely in arms” [1]. Deep vein thrombosis is the cardiovascular disease in which one or more than one blood clot is formed in large veins of human body. In acute phase of disease these patients are treated with mechanical- and catheter-directed thrombolysis (CDT), which causes the rapid lysis of thrombus and decreases the risk of increased incidence of post-thrombotic syndrome [3,4]. Such procedures are often used to manage acute ischemia of the limbs due to arterial thrombosis, but there is an elevated risk of ischemiareperfusion damage [5,6]. Thrombolytic treatment is directly correlated with higher risk of bleeding that increased the risk of mortality in patients of DVT [7,8,9,10]

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