Secondary prophylaxis decision-making in venous thromboembolism: interviews on clinical practice in thirteen countries.

OBJECTIVES

Secondary prevention of venous thromboembolism (VTE) remains a topical and contentious point of debate for thrombosis experts around the globe. This discussion centers around two aspects: optimum treatment duration and which type and dosage of thromboprophylaxis to prescribe. Collectives of thrombosis experts have tried to steer the debate by issuing periodical best-practice guidelines. However, the lack of adherence to said guidelines is such that there is a growing body of research devoted to this very problem. Most of the studies on the subject retrospectively observe a single setting, which leaves important questions as to the generalizability of their findings. As each setting appears to face its own unique challenges, the overarching question of why there is so much variance between physicians when it comes to the secondary prevention of VTE is never fully addressed.

METHODS

For this study, we asked thirteen senior-level physicians representing equally as many countries about the current state of clinical practice regarding the secondary prevention of VTE.

RESULTS

The discussion identifies several barriers to adequate VTE prevention, and hints at area-specific idiosyncrasies that may explain why physicians from different locales treat VTE patients differently.

CONCLUSION

Universal treatment guidelines may not fully translate to clinical practice in many areas, and that promoting local guidelines to supplement the universal guidelines may be beneficial.