Rory Wallace1,2, Mary-Ann Anderson3,4, Katharine See1, Alexandra Gorelik5,6, Louis Irving1,7,8, Renee Manser1,8. 1. Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 2. Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia. 3. Department of Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 4. Division of Cancer and Haematology, Walter Eliza Hall, Melbourne, Victoria, Australia. 5. Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia. 6. Melbourne EpiCentre, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 7. Lung Health Research Centre, School of Biomedical Sciences, University of Melbourne, Melbourne, Victoria, Australia. 8. Department of Medical Oncology and Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Current international clinical practice guidelines do not adequately address all clinical scenarios in the management of venous thromboembolism (VTE), and no comprehensive Australian guidelines exist. AIMS: To identify areas of uncertainty in VTE management and whether self-reported practice is consistent with guidelines. METHODS: We conducted an Australian cross-sectional online survey consisting of 53 questions to investigate doctors' VTE management practices. The survey was distributed to consultant and trainee/registrar haematologists and respiratory physicians with the aid of participating medical societies. RESULTS: A total of 71 haematologists and 110 respiratory physicians responded to the survey. The majority of survey respondents were 31-50-years old and worked in teaching hospitals and in the acute care setting. Under-treatment was reported for high-risk pulmonary embolism (PE) and duration of anticoagulation for first-episode unprovoked PE (32 and 83% respectively). Over-treatment was reported in areas of thrombolysis for intermediate-risk PE (16%) and duration of anticoagulation for first-episode provoked PE (41%). Uncertainty and variations in doctors' management approaches were also found. CONCLUSION: This survey demonstrated significant over-treatment, under-treatment and variability in the practice of VTE management. The findings highlight the need for the development and implementation of national guidelines for the management of VTE in Australia.
BACKGROUND: Current international clinical practice guidelines do not adequately address all clinical scenarios in the management of venous thromboembolism (VTE), and no comprehensive Australian guidelines exist. AIMS: To identify areas of uncertainty in VTE management and whether self-reported practice is consistent with guidelines. METHODS: We conducted an Australian cross-sectional online survey consisting of 53 questions to investigate doctors' VTE management practices. The survey was distributed to consultant and trainee/registrar haematologists and respiratory physicians with the aid of participating medical societies. RESULTS: A total of 71 haematologists and 110 respiratory physicians responded to the survey. The majority of survey respondents were 31-50-years old and worked in teaching hospitals and in the acute care setting. Under-treatment was reported for high-risk pulmonary embolism (PE) and duration of anticoagulation for first-episode unprovoked PE (32 and 83% respectively). Over-treatment was reported in areas of thrombolysis for intermediate-risk PE (16%) and duration of anticoagulation for first-episode provoked PE (41%). Uncertainty and variations in doctors' management approaches were also found. CONCLUSION: This survey demonstrated significant over-treatment, under-treatment and variability in the practice of VTE management. The findings highlight the need for the development and implementation of national guidelines for the management of VTE in Australia.
Authors: Gualtiero Palareti; Angelo A Bignamini; Michela Cini; Young-Jun Li; Tomasz Urbanek; Juraj Madaric; Kamel Bouslama; German Y Sokurenko; Giuseppe M Andreozzi; Jiří Matuška; Armando Mansilha; Victor Barinov Journal: Clin Appl Thromb Hemost Date: 2021 Jan-Dec Impact factor: 2.389
Authors: Tamara Mertins; Henning Nilius; Robin Boss; Matthias Knuchel; Andri Signorell; Carola A Huber; Eva Blozik; Johanna Anna Kremer Hovinga; Lucas M Bachmann; Michael Nagler Journal: Front Cardiovasc Med Date: 2022-08-03