European expert consensus recommendations on the primary care use of direct oral anticoagulants in patients with venous thromboembolism.
Background: Direct oral anticoagulants for the treatment of venous thromboembolism are supported by robust clinical trial evidence. Despite published guidance, general practitioners are faced with increasingly complex decisions and implementation remains sub-optimal in certain real-world scenarios....
| Publicado en: | BMC Primary Care Vol. 25; no. 1; pp. 1 - 11 |
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| Autores principales: | , , , , , , , |
| Formato: | critical path practice guidelines research tables/charts Journal Article |
| Publicado: |
BioMed Central
3/18/2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176627920&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176627920 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27314553 MZZU jtl: BMC Primary Care issn: 27314553 maglogo: N pubinfo: dt: 3/18/2024 vid: 25 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 176627920 176627920 176627920 10.1186/s12875-024-02314-7 176627920 ppf: 1 ppct: 10 formats: tig: atl: European expert consensus recommendations on the primary care use of direct oral anticoagulants in patients with venous thromboembolism. aug: au: Patrice, Carter Ahmet, Fuat Sylvia, Haas Elizabeth, Smyth Carlos, Brotons Frank, Cools Rupert, Bauersachs Richard, Hobbs F. D. affil: https://ror.org/047933096 Health Economics & Outcomes Research Ltd, Rhymney House, Unit A Copse Walk, Cardiff Gate Business Park, CF23 8RB, Cardiff, UK sug: subj: Venous Thromboembolism Drug Therapy Anticoagulants Administration and Dosage Administration, Oral Practice Guidelines Consensus Primary Health Care Europe Physicians, Family Medical Practice, Evidence-Based Human Europe Delphi Technique Questionnaires Physician Attitudes After Care Drug Efficacy Neoplasms Complications Family Practice Summated Rating Scaling Focus Groups Descriptive Statistics Decision Making, Shared Referral and Consultation International Normalized Ratio Venous Thromboembolism Risk Factors Drug Interactions Anticoagulants Contraindications Kidney Diseases Treatment Duration Anticoagulants Adverse Effects Drug Substitution Funding Source ab: Background: Direct oral anticoagulants for the treatment of venous thromboembolism are supported by robust clinical trial evidence. Despite published guidance, general practitioners are faced with increasingly complex decisions and implementation remains sub-optimal in certain real-world scenarios. Methods: A two stage formal consensus exercise was performed to formulate consensus statements and a summary guide, facilitating optimal management of direct oral anticoagulants in venous thromboembolism patients by generalist physicians across Europe. An online questionnaire distributed to a broad panel (Phase 1), followed by a virtual panel discussion by an expert group (Phase 2) were conducted. Phase 1 statements covered nine management domains, and were developed via a literature review and expert steering committee. Participants rated statements by their level of agreement. Phase 1 responses were collated and analysed prior to discussion and iterative refinement in Phase 2. Results: In total 56 participants from across Europe responded to Phase 1. The majority had experience working as general practitioners. Consensus indicated that direct oral anticoagulants are the treatment of choice for managing patients with venous thromboembolism, at initiation and for extended treatment, with a review at three to six months to re-assess treatment effect and risk profile. Direct oral anticoagulant choice should be based on individual patient factors and include shared treatment choice between clinicians and patients; the only sub-group of patients requiring specific guidance are those with cancer. Conclusion: Results demonstrate an appreciation of best practices, but highlight challenges in clinical practice. The patient pathway and consensus recommendations provided, aim to highlight key considerations for general practice decision making, and aid optimal venous thromboembolism treatment. pubtype: Academic Journal doctype: critical path practice guidelines research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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