This study explores the factors that influence doctors when they decide how best to treat a patient who has both advanced cancer and VTE. The current evidence suggests that if Low Molecular Weight Heparin (LMWH) is used long-term, the chances of a patient with advanced cancer experiencing a recurrent VTE is halved compared with the use of warfarin. However, many doctors still prescribe warfarin, and sometimes in people with advanced cancer, may not consider anticoagulation at all, even for people who are still reasonably active.
We are planning to investigate the views of 45 clinicians across three specialities - oncologists, palliative care consultants and GPs. The project is taking place in two locations: the Humber and Yorkshire region of England and in South Wales. It is a two part study, using qualitative methodology. In the first part, we present clinical case scenarios to doctors and ask them to ‘think aloud’ their thoughts on how they would manage and decide how to treat the clinical case described in the scenario. The second part of the study uses the in depth interview method to explore the decision making factors in more detail, including the barriers which may currently inhibit doctors applying current guidelines in the management of VTE in advanced cancer patients.