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Patients' perceptions and experiences of the prevention of hospital-acquired thrombosis: a qualitative study
  1. Patricia N Apenteng1,
  2. David Fitzmaurice1,
  3. Ian Litchfield1,
  4. Sian Harrison2,
  5. Carl Heneghan2,
  6. Alison Ward2,
  7. Sheila Greenfield1
  1. 1Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  2. 2Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Professor Sheila Greenfield; S.M.GREENFIELD{at}


Objective To examine patients' understanding of hospital-associated thrombosis, and their experiences of thromboprophylaxis.

Design Qualitative study using semi-structured interviews with 31 patients requiring venous thromboembolism (VTE) prophylaxis following a recent hospital admission. Interviews were audio-recorded, transcribed verbatim and analysed thematically using framework analysis.

Setting 4 hospitals in Birmingham and Oxford.

Results All the participants received thromboprophylaxis following surgical procedures. Participants were aware of a risk of blood clots; however, they lacked a good understanding of VTE and its components. Experiences of VTE prophylaxis were characterised with good adherence to heparin injections and poor adherence to elastic compression stockings, largely due to perceived lack of clarity in guidance from health professionals. Participants had limited knowledge of the signs and symptoms of VTE and would value improved education on VTE.

Conclusions Findings suggest that patient education is often inadequate and impacts negatively on patients' involvement in VTE prevention. An enhanced patient education programme incorporating a consistent message on the appropriate use of elastic compression stockings and description of VTE symptoms is likely to optimise the effectiveness of the prevention of hospital-associated thrombosis. Physicians may use the results of this study to improve individual patient education.

  • venous thromboembolism
  • prophylaxis
  • patient education
  • deep vein thrombosis
  • pulmonary embolism

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors PNA contributed to the analysis and interpretation of the data and drafted the manuscript. DF, CH, AW and SG contributed to the conception and design of the study, analysis and interpretation and revised the work critically for intellectual content. SG is also the guarantor for the study. SH contributed to the conduct of the study, contributed to data analysis and revised the work critically for intellectual content. IL contributed to the analysis and interpretation of study data and revised the work critically for intellectual content. All authors approved the final version of the manuscript, and are accountable for all aspects of the work.

  • Funding This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) Programme (grant number RP-PG-0608-10073).

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Ethics approval Ethical approval for the study was granted by the Oxfordshire REC B Research Ethics Committee (reference: 11/H0605/5).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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