Knowledge gaps in patients with venous thromboembolism: usefulness of a new questionnaire

Abstract

in 24 455 patients showed that the rates of recurrent VTE, fatal PE, and all-cause mortality were similar to the NOACs; however, the rate of major bleeding was significantly lower with the NOACs than with warfarin. 2,4 Due to convenience in use and no need for routine monitoring, the number of patients with VTE and atrial fibrillation (AF) who take NOACs increase worldwide. Recent data from the RIETE registry 5 showed that a nonnegligible proportion of VTE patients received nonrecommended doses and regimens of NOACs, which was associated with a higher rate INTRODUCTION Venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), occurs in about 1 in 1000 persons each year. 1,2 There is evidence that VTE is often asymptomatic, underdiagnosed, and undertreated. 3 For more than 60 years, vitamin K antagonists (VKAs) were the mainstay of VTE treatment. Non-vitamin K antagonist oral anticoagulants (NOACs) have altered the landscape of treatment options. A meta-analysis of the 5 phase III trials comparing 4 NOACs (rivaroxaban, dabigatran, apixaban, and edoxaban) with warfarin

Polish regional differences in patient knowledge on atrial fibrillation and its management as well as in patterns of oral anticoagulant prescription

“…Patients on different non-vitamin K antagonist oral anticoagulants In the whole group, the proportion of patients on rivaroxaban and dabigatran were similar (43.1% and 43.0%, respectively), and the apixaban group was much smaller (13.9%). Patients taking apixaban, as compared with those on rivaroxaban and dabigatran, were the oldest (median [IQR], I, 76 [68-81]; II, 71 [64-78]; III, 71 [63-78] years; P = 0.0002) and received anticoagulant therapy for the shortest time (I, 4 [1][2][3][4][5][6][7][8][9][10]; II, 14 [6-27]; III, 11 [3-24] months; P <0.0001). Patients on apixaban more often received concomitant antiplatelet treatment (aspirin, I, 26.1%; II, 13.4%; III, 13.9 %; P = 0.001; clopidogrel, I, 20.4%; II, 6.1%; III, 5.7%; P <0.0001).…”

“…In the European registry, the Xarelto for Prevention of Stroke in Patients with Atrial Fibrillation (XANTUS), improve the effectiveness and safety of anticoagulant therapy. We postulated the development and implementation of a national educational program based on validated questionnaires and directed towards patients who require lifelong anticoagulation, including those with recurrent venous thromboembolism, as they had similar knowledge gaps regarding the use of OAC, 10 to improve clinical outcomes.…”

Increased levels of histidine-rich glycoprotein are associated with the development of post-thrombotic syndrome

“…It should be highlighted that the current study showed a relatively high percentage of severe PTS patients and recurrent events among them. This unexpected finding might be related to several issues, such as the lack of anticoagulation clinics in Poland, which are known to offer the best long-term care for patients with PTS together with education 35 . Most patients referred to our clinic had more severe clinical course of DVT, they had mostly proximal DVT (75%).…”

Where to treat patients with acute pulmonary embolism?

“…Moreover, a sufficiently high level of outpatient care is necessary to ensure anticoagulant therapy and to provide adequate education regarding the management of venous thromboembolism and prompt medical support when needed. [22][23][24] As mentioned above, apart from clinical, imaging, and laboratory data that help assess PE severity and PE -related early death, comorbidities should be considered to evaluate the overall mortality risk and early outcome. The Pulmonary Embolism Severity Index (PESI) and especially its simplified version, sPESI, 25,26 have been validated and are widely used mostly for identification of patients at low risk of 30-day mortality (sPESI score = 0; TABLE 1).…”