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Effectiveness of a multidisciplinary care program for the management of venous thromboembolism in cancer patients: a pilot study

Abstract

Introduction

Treatment of Venous thromboembolism (VTE) in cancer patients is challenging due to higher risk of VTE recurrence or bleeding under anticoagulants. We assessed the effectiveness of a dedicated “Allo-Thrombosis Cancer” multidisciplinary care program (AlloTC-MCP) that incorporated individualized care, regular follow-ups, telephone counselling, and a patient education program.

Methods and materials

From September 2017 to October 2019, 100 consecutive cancer patients with new VTE onset were enrolled in this observational single-center prospective pilot study and received standard (control group, n = first 50 patients enrolled) or AlloTC-MCP care (n = next 50 patients enrolled) over a 6-month VTE treatment follow-up period. Primary end-point was the percentage of adherence to the International Clinical Practice Guidelines (ITAC-CPGs) at 6 (M6) month follow-up.

Results

Among the 100 patients with different cancer types (22% genitourinary, 19% breast, 16% gastrointestinal, 15% lymphoma, 11% lung and 17% others), 51 patients (61%) had metastatic disease and 31 (31%) received chemotherapy alone. Main baseline cancer and VTE clinical characteristics did not differ between the 2 groups. Adherence rates to ITAC-CPGs was significantly higher in the AlloTC-MCP group (100% (M0), 72% (M3) and 68% (M6)) compared with the control group (84% (M0), 8% (M3) and 16% (M6)). Quality of Life (QoL) was significantly improved in the AlloTC-MCP group 6 months after inclusion.

Conclusion

The “AlloTC-MCP” was associated with improved adherence to ITAC-CPGs and merits further expansion.

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Acknowledgements

We thank Prof. Henri Bounameaux for reading and providing thoughtful comments on this manuscript. We acknowledge the contribution of Kristell Desseaux in data analysis.

Funding

APHP research grant “Parcours de soins 2017”.

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Correspondence to Dominique Farge.

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Benzidia, I., Crichi, B., Montlahuc, C. et al. Effectiveness of a multidisciplinary care program for the management of venous thromboembolism in cancer patients: a pilot study. J Thromb Thrombolysis (2021). https://doi.org/10.1007/s11239-021-02512-5

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Keywords

  • Venous thromboembolism
  • Cancer
  • Anticoagulant
  • Multidisciplinary care program
  • Clinical practice guidelines
  • Quality of life