ArticleJCO oncology practice2020
Successful Model for Guideline Implementation to Prevent Cancer-Associated Thrombosis: Venous Thromboembolism Prevention in the Ambulatory Cancer Clinic.
Article in JCO oncology practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Anticoagulation for the prevention of arterial thromboembolism in cancer patients by primary tumour site: a systematic review and meta-analysis of randomized trials.European heart journal. Cardiovascular pharmacotherapy · 2025Pooled it
- Incidence of Venous Thromboembolism in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Neoadjuvant Chemotherapy.Annals of surgical oncology · 2026Article
- The public health impact of cancer-associated venous thromboembolism: looking to the future.Research and practice in thrombosis and haemostasis · 2026Article
- Implementation failure: thromboprophylaxis in ambulatory patients with cancer.Hematology. American Society of Hematology. Education Program · 2025Review
- Time to move beyond risk assessment models for ambulatory cancer-associated thrombosis.Research and practice in thrombosis and haemostasis · 2025Article
- Identifying and addressing underuse in hematologic care through systems-based hematology.Research and practice in thrombosis and haemostasis · 2025Review
- Patient's Awareness of Cancer-Associated Thrombosis: A Canadian Nationwide Survey.TH open : companion journal to thrombosis and haemostasis · 2025Article
- Venous thromboembolism prevention program implementation in a community oncology practice: a cohort study.Lancet regional health. Americas · 2024Article
- DNA liquid biopsy-based prediction of cancer-associated venous thromboembolism.Nature medicine · 2024Article
- Preventing venous thromboembolism for ambulatory patients with cancer: Developing the form and content of implementation strategies.Thrombosis update · 2024Article
- Review
- Implementation of a cancer-associated thrombosis prevention program at a rural cancer center.Research and practice in thrombosis and haemostasis · 2024Article
- Venous thromboembolism prevention in cancer care: implementation strategies to address underuse.Research and practice in thrombosis and haemostasis · 2023Article
- Prophylactic Anticoagulation in Patients with Cancer: When and How?Current oncology reports · 2023Review
- Implementing guidelines to prevent cancer associated thrombosis: how can we do better?Research and practice in thrombosis and haemostasis · 2023Review
- Prediction of venous thromboembolism incidence in the general adult population using two published genetic risk scores.PloS one · 2023Article
- Treatment and prevention of cancer-associated thrombosis in the Netherlands: A national survey.Research and practice in thrombosis and haemostasis · 2023Article
- Cancer-Associated Thrombosis: Epidemiology, Pathophysiological Mechanisms, Treatment, and Risk Assessment.Clinical Medicine Insights. Oncology · 2023Review
- Barriers and facilitators to preventing venous thromboembolism in oncology practice.Thrombosis research · 2022Article
- Multidisciplinary Care for the Prevention and Treatment of Venous Thromboembolism in Patients with Cancer-Associated Thrombosis (CAT): Impact of Educational Interventions on CAT-Related Events and on Patients' and Clinicians' Awareness.Life (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGuidelines recommend venous thromboembolism (VTE) risk assessment in outpatients with cancer and pharmacologic thromboprophylaxis in selected patients at high risk for VTE. Although validated risk stratification tools are available, < 10% of oncologists use a risk assessment tool, and rates of VTE prophylaxis in high-risk patients are low in practice. We hypothesized that implementation of a systems-based program that uses the electronic health record (EHR) and offers personalized VTE prophylaxis recommendations would increase VTE risk assessment rates in patients initiating outpatient chemotherapy. PATIENTS AND
methodsVenous Thromboembolism Prevention in the Ambulatory Cancer Clinic (VTEPACC) was a multidisciplinary program implemented by nurses, oncologists, pharmacists, hematologists, advanced practice providers, and quality partners. We prospectively identified high-risk patients using the Khorana and Protecht scores (≥ 3 points) via an EHR-based risk assessment tool. Patients with a predicted high risk of VTE during treatment were offered a hematology consultation to consider VTE prophylaxis. Results of the consultation were communicated to the treating oncologist, and clinical outcomes were tracked.
resultsA total of 918 outpatients with cancer initiating cancer-directed therapy were evaluated. VTE monthly education rates increased from < 5% before VTEPACC to 81.6% (standard deviation [SD], 11.9; range, 63.6%-97.7%) during the implementation phase and 94.7% (SD, 4.9; range, 82.1%-100%) for the full 2-year postimplementation phase. In the postimplementation phase, 213 patients (23.2%) were identified as being at high risk for developing a VTE. Referrals to hematology were offered to 151 patients (71%), with 141 patients (93%) being assessed and 93.8% receiving VTE prophylaxis.
conclusionVTEPACC is a successful model for guideline implementation to provide VTE risk assessment and prophylaxis to prevent cancer-associated thrombosis in outpatients. Methods applied can readily translate into practice and overcome the current implementation gaps between guidelines and clinical practice.
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