5PSQ-006 An exploration of non-consultant doctors’ views, and current practices, of prescribing thromboprophylaxis, for patients with chronic liver disease
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance Previous studies have shown prescribing rates of thromboprophylaxis to be suboptimal in patients with chronic liver disease (CLD). Challenges faced by doctors include the uncertain balance between bleeding and thrombosis risk, and the limited data available to guide their decision making in this patient cohort. Aim and Objectives To determine non-consultant doctors’ views, and current practices of prescribing thromboprophylaxis, for patients with CLD. To determine which variables, affect doctors’ confidence determining if thromboprophylaxis is appropriate for patients with CLD, and their current practices of same. To determine if doctors’ views and current practices agree with clinical guidelines. Material and Methods A questionnaire was designed and distributed to non-consultant doctors in the hospital. The questionnaire was based on current literature and clinical guidelines. Data were analysed using SPSS. Results Twenty-four doctors (45.3%) felt confident determining if thromboprophylaxis should be prescribed for patients with CLD. The majority of doctors felt it was important to complete the VTE Risk Assessment (98.1%), to regularly review the need for thromboprophylaxis (92.5%), and that patients with CLD can be at an increased risk of thromboembolism even with a prolonged prothrombin time (71.7%). For patients with CLD with risk factors for VTE and without a contraindication to anticoagulation, most doctors (98.1%) prescribed thromboprophylaxis. Eleven doctors (20.8%) prescribed thromboprophylaxis regardless of the INR figure. Amongst those doctors who took the INR figure into account, the INR threshold above which doctors would not prescribe thromboprophylaxis varied greatly. The platelet count below which doctors would not prescribe thromboprophylaxis varied also. Clinical situations in which doctors felt thromboprophylaxis was not appropriate included an active bleed, an upper gastrointestinal bleed, and low platelets. Doctors’ title/grade, years of experience, and gastroenterology experience influenced their confidence and prescribing practices. One doctor was aware of a guideline on thromboprophylaxis prescribing in CLD, and all doctors surveyed would feel more confident having access to a guideline. Conclusion and Relevance The prescribing practices of doctors were, to some extent, in accordance with the limited guidelines currently available. Access to, and teaching on, the guidelines is recommended to improve doctors’ confidence and compliance with guidelines. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: M Kinnane, M Hughes, C Kiat, B Addison, D Lynch
Institutions: Cork University Hospital, Robert Gordon University
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408377125