Patient perspectives on inferior vena cava filter retrieval.

OBJECTIVE

Inferior vena cava (IVC) filter retrieval rates remain low. Previous literature identified provider and system factors to enhance retrieval, but patients' perspectives have not been studied. This study compared the attitudes of men and women with retained filters to identify patient factors that would increase compliance and facilitate retrieval when indicated.

METHODS

A retrospective single-center review of all patients undergoing IVC filter placement between 2009 and 2011 was performed. The electronic medical records were reviewed to identify patients with retained filters who were potential candidates for removal. Patients' demographics, comorbidities, and indication for filter placement were noted. A telephone survey inquiring about the patient's awareness of IVC filters and risks of leaving them permanently in place was conducted. Additional questions addressed patient-physician relations, preferences in communication, and attitudes toward television commercials on IVC filter lawsuits. Patients' characteristics and survey responses were compared between men and women.

RESULTS

There were 604 patients who underwent IVC filter placement. The overall retrieval rate was 30%. Telephone survey was conducted for 42 patients with retained filters who were identified as possible candidates for retrieval. There was no difference between the men and women in terms of demographics and comorbidities. The survey demonstrated that 12% of patients were not aware of having an IVC filter, and only 23% knew that it can be removed. Women were significantly more likely than men to know the risks and benefits of IVC filter placement (42.8% vs 14.2%; P <. 03), but there was no significant difference in knowledge of the long-term complications of indwelling filters. Even though the majority of patients (88%) had an established relation with a primary care provider, only 21.4% followed up with the team of physicians of the hospitalization for IVC filter placement. Better education about IVC filters would have improved follow-up in the opinion of 97.6% of patients. Also, 50% relocated since filter placement and 35.7% changed their telephone number. There was no difference regarding use of Internet and interest in receiving educational material, but women (42.8%) significantly preferred receiving health-related communication by electronic mail, whereas men (64%) preferred telephone calls (P = .03). The majority of patients (59.5%) had watched commercials for IVC filter lawsuits, among whom 26% claimed to seek discussion with a medical provider after watching the commercial. The predominant cause for no follow-up was "unaware of risks of leaving the filter" (69%).

CONCLUSIONS

In this era of modern medicine, vascular specialists must educate the patient and family about IVC filters and long-term effects to optimize the patient's compliance. Electronic communication for follow-up may help capture patients who relocate and change phone numbers and seems to be particularly attractive to women.