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

Expert Rev Hematol. 2023 Feb;16(2):147-150. doi: 10.1080/17474086.2023.2162499. Epub 2022 Dec 28.

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; adherence; enoxaparin; prophylaxis; sickle cell disease.

MeSH terms

  • Adult
  • Anemia, Sickle Cell* / complications
  • Anemia, Sickle Cell* / drug therapy
  • Anticoagulants / therapeutic use
  • Enoxaparin / therapeutic use
  • Humans
  • Retrospective Studies
  • Venous Thromboembolism* / epidemiology
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / prevention & control

Substances

  • Enoxaparin
  • Anticoagulants