Pharmacist-Led Discharge Counseling and Adherence to Postpartum Venous Thromboembolism Prophylaxis: A Pre–Post Observational Study
Manal A. Behisi, Reem F. Bamogaddam, Amani Z. Alotaibi, Hajar A. Almutairi, Eiman M. Fallatah, Fuddah M. Assiri, Ibrahim M. Alalmai, Munirah H. Alohaydib, Nada A. Nawab, Ohoud M. Alotaibi, Omamah S. Aldosari, Waleed Tharwat AletrebyBackground
Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality, during postpartum period. It may be mitigated through pharmacological and non-pharmacological interventions. However, adherence to prevention measures and patient education remain critical to optimizing outcomes.
Methods
A pre–post observational study. The pre-intervention (PRE) phase was a retrospective review of postnatal women receiving pharmacological prophylaxis without counseling (January–December 2024), in the post-intervention (POST) phase eligible women received standardized pharmacist-led discharge counseling (January–December 2025). Medication adherence, complications, and VTE events were assessed via structured telephone interviews. The primary outcome was adherence to VTE prophylaxis; secondary outcomes included confirmed or suspected VTE, and patient satisfaction in the post-intervention group only.
Results
A total of 459 postnatal women were included. Adherence to VTE prophylaxis was higher in the POST group (91.2% vs. 77.8%; p < 0.001), while reported complications showed a trend of lower incidence (11.5% vs. 18.2%; p = 0.045). The incidence of confirmed or suspected VTE was lower but not statistically significance (1.1% vs. 3%; p = 0.2). No reported difficulties with medication administration in the POST group. Patient satisfaction was high (99.6%). In exploratory analysis, elective cesarean section was the only factor significantly associated with VTE occurrence (p = 0.026).
Conclusion
Structured pharmacist-led discharge counseling significantly improved adherence to postpartum VTE prophylaxis, reduced treatment-related complications, and was associated with high patient satisfaction. The observed trend in reduction of VTE suggests potential clinical benefit. Pharmacist-led education during postnatal care may be associated with higher self-reported adherence of VTE prevention strategies.