title: Have palliative care teams' attitudes toward venous thromboembolism changed? A survey of thromboprophylaxis practice across British specialist palliative care units in the years 2000 and 2005.
abstract: Palliative care patients are highly prothrombotic, yet there are no national guidelines for the prevention of venous thromboembolism (VTE). A survey was undertaken to explore thromboprophylaxis practice within British palliative care inpatient units and whether it changed over 5 years in keeping with emerging evidence. A descriptive semistructured telephone survey was conducted in April, 2000 and March, 2005 to explore current thromboprophylaxis practice. Seventy-four percent of units participated in 2000 and 91% participated in 2005. Units surveyed in 2000 revealed that 2% had thromboprophylaxis guidelines and up to 75% would stop ongoing low molecular weight heparin (LMWH) in a highly prothrombotic, good prognosis inpatient. The survey in 2005 indicated that thromboprophylaxis guidelines were being developed in 19% of units and only 18% of units surveyed would stop LMWH in a patient already receiving thromboprophylaxis (P < 0.001). There appears to be a growing awareness of the problem of VTE in British palliative care inpatients, as evidenced by changes in attitudes and practice. Reasons for this are discussed.
authors.affiliation: Cardiff University, Velindre Hospital, Cardiff, Wales, UK. simon.noble@velindre-tr.wales.nhs.uk
authors.forename: Simon I R
authors.initials: SI
authors.lastname: Noble
authors.forename: Ilora G
authors.initials: IG
authors.lastname: Finlay
mesh_terms: D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006801:Humans; D010166:Palliative Care; D017410:Practice Guidelines as Topic; D013923:Thromboembolism / Q000517:prevention & control*; D006113:United Kingdom; D020246:Venous Thrombosis / Q000517:prevention & control*