Evidence map›Paper›PMID 30488789›Full record

Trial reportPalliative medicine2019

Oral anticoagulation is preferable to injected, but only if it is safe and effective: An interview study of patient and carer experience of oral and injected anticoagulant therapy for cancer-associated thrombosis in the select-d trial.

Ann Hutchinson, Sophie Rees, Annie Young, Anthony Maraveyas, Kathryn Date, Miriam J Johnson

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Palliative medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Trial
  5. Article
  6. Quality of life in oncological patients with venous thromboembolic disease.Research and practice in thrombosis and haemostasis · 2024
    Review
  7. Article
  8. Review
  9. Review
  10. Review
  11. Review
  12. Cancer-associated venous thromboembolism.Nature reviews. Disease primers · 2022
    Review
  13. Observational
  14. Consensus statement of the Spanish Society of Internal Medicine and the Spanish Society of Medical Oncology on secondary thromboprophylaxis in patients with cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021
    Article
  15. Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ann Hutchinson1 University of Hull, Hull, UK.ORCID 0000-0001-9480-9764
Sophie Rees2 University of Warwick, Coventry, UK.ORCID 0000-0003-4399-2049
Annie Young2 University of Warwick, Coventry, UK.
Anthony Maraveyas1 University of Hull, Hull, UK.
Kathryn Date1 University of Hull, Hull, UK.
Miriam J Johnson1 University of Hull, Hull, UK.ORCID 0000-0001-6204-9158

Funding

Department of Health PB-PG-0614-34007Department of Health PB-PG-1207-15033
6 · The paper itself

Abstract

backgroundCancer patients have a four- to fivefold greater risk of thrombosis than the general population. Recommended treatment for cancer-associated thrombosis is 3-6 months of low-molecular-weight heparin. The 'select-d' trial is an open-label, randomised, multi-centre pilot trial in patients with cancer-associated thrombosis, utilising dalteparin (low-molecular-weight heparin) versus rivaroxaban (a direct oral anticoagulant), to assess effectiveness and safety.

aimTo explore patient and informal carers' experiences of cancer-associated thrombosis and their experience and understanding of the risk-benefit of thrombosis treatment.

designQualitative substudy of the select-d trial, using semi-structured interviews. Interviews were audio-recorded and transcribed. Data were analysed using Framework Analysis.

participantsParticipants were purposively sampled ( n = 37 patients; 46% male; age 40-89; 9 with carer present).

resultsThree themes were found: experience of cancer-associated thrombosis, experience of anticoagulation and risk-benefit balance of the two modes of administration. Some were shocked by their thrombosis diagnosis (most were unaware of their risk), but others found it insignificant compared with cancer. Most patients found tablets more convenient, but injections were acceptable in the context of having cancer. While most were happy to follow medical advice, others weighed preference on the basis of effectiveness.

conclusionLack of awareness of thrombosis risk is concerning; cancer patients must be informed to enable prompt help-seeking. Tablets could provide a welcome choice for patients if there is equivalent risk-benefit to injected anticoagulants. Patients trust their clinicians to tailor their treatment. Future research could explore the effect of routine information giving about the risk of thrombosis.

Indexed as

Patient SatisfactionAdministration, OralAdultAgedAged, 80 and overAnticoagulantsDalteparinFactor Xa InhibitorsFemaleHumansInjectionsMaleMiddle AgedNeoplasmsRivaroxabanVenous ThrombosisAnticoagulantsDalteparinFactor Xa InhibitorsRivaroxabananticoagulantsdirect oral anticoagulantsinjectionsinterviewlow-molecular-weight heparinsneoplasmstabletsThrombosis

Identifiers

PMID30488789
PMCPMC6506899

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.