A Survey of Clinicians Practice Patterns in Anticoagulation Therapy & Prophylaxis in Nigeria

Introduction: Therapeutic and prophylactic anticoagulation is under-prescribed in Nigeria, Dismal practice patterns of anticoagulation, lack of hospital-based anticoagulation policy may be contributory. Objective: The aim was to evaluate clinicians practice patterns in anticoagulation therapy and prophylaxis in Nigeria. Materials and Methods: The study was a multi-centre survey using pretested validated questionnaire administered to 528 clinicians in some tertiary hospitals in South East Nigeria. The primary outcome measure was the practice pattern of anticoagulation therapy and prophylaxis. A p-value < 0.05 was considered as statistically significant. Data analysis was with Statistical Package for Social Science (SPSS) software, version 18 (SPSS Inc., Chicago, IL). Results: We discovered that only 52 respondents (9.8%) claimed their institutions had an anticoagulation policy. The most prescribed anticoagulation agent was low molecular weight heparin (LMWH), (AOR 163, 95% CI 0.85-0.3.14, P=0.19) while the fondaparinux was least prescribed (AOR 1.74, 95% CI 0.61-5.0 P=0.44). Only 193 (36.6%) of the respondents routinely prescribed anticoagulation therapy when indicated. Those with 15-20 years clinical experience identified cost is an important determinant in prescribing anticoagulation agents. (P=0.06, 95%CI 0.94 -12.4). Conclusion: The study showed the need to establish policy or guideline driven dedicated anticoagulation clinic services as well as practice-oriented CMEs to stem anticoagulation-related morbidity and mortality