Management of venous thromboembolism in the palliative care setting.
Recent literature has highlighted the unique challenges facing professionals involved with the management of venous thromboembolism (VTE) in cancer patients. Although research favours the use of low molecular weight heparin (LMWH) rather than warfarin, no studies have been conducted exclusively in the palliative care population. Likewise, active treatment may not always be appropriate in the advanced cancer patient. This paper highlights the issues to be considered when facing a palliative care patient and suspected VTE. In particular, consideration must be given to the practicalities and acceptability of investigating suspected VTE, the dose and length of anticoagulation, and management of the patient nearing death. An understanding of the current evidence must be applied to the individual patient, taking into account their needs and wishes.
Noble
Simon
S
Cardiff University, UK. simon.noble@gwent.wales.nhs.uk
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D016903:Drug Monitoring; D019317:Evidence-Based Medicine; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D019934:International Normalized Ratio; D009369:Neoplasms / Q000150:complications; D010166:Palliative Care / Q000379:methods*; D026706:Paternalism; D010344:Patient Advocacy; D018579:Patient Selection; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin