Knowledge, Attitudes and Practices of Internal Medicine Residents Towards Deep Vein Thrombosis Prophylaxis in a University Hospital in Tehran

Deep Vein Thrombosis (DVT) is a major problem in hospitalized patients. There is discrepancy between healthcare providers’ knowledge and their clinical practice regarding DVT prophylaxis. In this study we aimed to evaluate knowledge, attitude and practices of internal medicine residents at an educational hospital in Tehran.
This cross-sectional study was conducted during December 2015 at Shariati hospital of Tehran, IRAN. A questionnaire covering five domains of clinical scenarios, adherence to guidelines, personal beliefs, practice, preferences and personal beliefs, was distributed between internal medicine residents. Medical records of patients at the internal ward were reviewed to assess the status of DVT prophylaxis in patients, who needed DVT prophylaxis based on American college of chest physicians’ (ACCP) guidelines.
Overall, 71 residents out of 88 residents returned the questionnaire, and 43.7% were aware of the guidelines. Furthermore, 97.2% thought DVT prophylaxis is clinically important but only 66.90% of the patients, who needed DVT prophylaxis, were receiving DVT prophylaxis. More than 50% of the residents underestimated the incidence of DVT and mortality rate due to pulmonary embolism. The most common reason for not prescribing DVT prophylaxis was concern about bleeding in 53.5% of the participants. Further analysis of different components of the questionnaire showed that there is a significant association between “awareness” and “adherence” scores (P = 0.041) and correct answers to “clinical scenarios” and “practice” (P = 0.012).
Although the level of knowledge on these clinical situations is good, underestimation of the risk of DVT development in hospitalized patients needs more attention. This might be due to low levels of awareness of presence and content of DVT prophylaxis guidelines. Programs should be designed to uphold the levels of information of DVT prophylaxis guidelines among internal medicine residents.