Ambulatory Patient Preference for VTE Prophylaxis

Introduction: Cancer-associated thrombosis leads to morbidity and mortality in cancer patients. Thromboembolism can be prevented with the use of existing and emerging anticoagulants. We sought to ascertain awareness as well as receptiveness to anticoagulation amongst ambulatory cancer patients receiving active therapy.

Methods: Two-hundred-fifty 12 question surveys were distributed to ambulatory cancer patients at the James P. Wilmot Cancer Center of the University of Rochester. Patients included in this study were those with active cancer, age ≥ 18 years and ambulatory. Hospitalized patients were excluded. Data was gathered regarding: age, gender, stage as well as type of malignancy, awareness of increased risk of venous thromboembolism and willingness to use various forms of anticoagulation.

Results: One hundred ninety surveys (76%) were completed over a three week period. Study population consisted of 71 males (37%) and 119 females (63%) with mean age of 58. Malignancies surveyed include: lymphoma 26%, breast 20%, gastrointestinal 15%, leukemia 9% and lung cancer 7% among others. Nineteen percent of patients had stage IV malignancy. Of the patients surveyed, 53% reported being unaware of the increased risk of VTE with malignancy. Eighty-six percent of patients surveyed would be willing to use an oral anticoagulant 46% would be willing to perform daily anticoagulant injections.

Conclusions: Prophylaxis for VTE in ambulatory cancer patients is an area of active investigation and could lead to improvements in morbidity and mortality. This study reveals a lack of knowledge of the increased risk of VTE amongst cancer patients. However, informed patients expressed willingness to use prophylaxis if shown effective to reduce VTE in the ambulatory setting.