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. 2021 Oct 7;5(Suppl 2):e12589. doi: 10.1002/rth2.12589
Profession/specialty groups Deciding which type of VTE treatment to use according to specific patient profile Using DOACs with cancer patients
Primary care physicians 71.9 (21.1) 63.3 (24.0)
Hematologists‐oncologists 73.4 (19.0) 75.1 (20.2)
Community oncologists 67.4 (22.6) 70.2 (21.5)
Emergency department physicians 60.3 (21.8) 57.4 (22.4)
VTE specialists (e.g., hematologists, cardiologists, pulmonologists, vascular medicine specialists) 73.5 (14.7) 67.7 (22.4)
Total 69.4 (20.6) 66.6 (23.0)
Asymptotic Significance (differences between profession/ specialty groups)* P = .006 P = .002
Representative quote

“With cancer patients often times their comorbidities make decision‐making more challenging. They may have metastatic disease that puts them at high risk for bleeding or, if they do bleed, at high risk for morbidity related to a bleed, particularly if they have intracranial metastases or spinal metastases. […] Some of these patients are very advanced, and by the time they’re diagnosed with VTE it’s pretty much the end of the road. So, discussions about what their goals of care are and end‐of‐life decision‐making—we’re not always equipped to do that very well.”

– ED Physician

“NOACs, those new anticoagulants, are still not approved in the cancer treatment patients, so technically we still need to use Coumadin if you want to be going by the book. […] so it’s a challenge, because Coumadin is an old drug and it’s hard to monitor. Because of their cancer, a patient may have problems with their monitoring parameters, which could be falsely elevated or decreased.”

– Community Oncologist

*

Kruskal Wallis H