Acceptability of low molecular weight heparin thromboprophylaxis for inpatients receiving palliative care: qualitative study.
OBJECTIVE
To find out what inpatients with advanced cancer who are receiving palliative care think about the effect of thromoprophylaxis on overall quality of life.


METHODS
Qualitative study using audiotaping of semistructured interviews.


METHODS
Regional cancer centre in Wales.


METHODS
28 inpatients with advanced metastatic cancer receiving palliative care and low molecular weight heparin.


METHODS
Recurring themes on the effect of thromboprophylaxis on overall quality of life.


RESULTS
Major emerging themes showed that patients knew about the risks of venous thromboembolism and the purpose of treatment with heparin. Media coverage had raised awareness about venous thromboembolism, and many had previous experience of thromboprophylaxis. All found low molecular weight heparin an acceptable intervention, and many said that it improved their quality of life by giving them a feeling of safety and reassurance. Antiembolic stockings were considered uncomfortable and had a negative impact on quality of life. Patients were concerned that because they had advanced disease they might not be eligible for thromboprophylaxis.


CONCLUSIONS
Low molecular weight heparin is acceptable to inpatients with advanced cancer receiving palliative care and has a positive impact on overall quality of life. Antiembolic stockings are an unacceptable intervention in this patient group. Guidelines on thromboprophylaxis are urgently needed for palliative care inpatient units and hospices.
Noble
S I R
SI
Cardiff University, Cardiff CF10 3XQ. simon.noble@gwent.wales.nhs.uk
Nelson
A
A
Turner
C
C
Finlay
I G
IG
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001458:Bandages; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D017060:Patient Satisfaction; D011788:Quality of Life; D013923:Thromboembolism / Q000517:prevention & control* / Q000523:psychology
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight