PMID- 23509484
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130704
LR  - 20211021
IS  - 1715-1635 (Print)
IS  - 1913-701X (Electronic)
IS  - 1715-1635 (Linking)
VI  - 145
IP  - 1
DP  - 2012 Jan
TI  - Prevention and treatment of venous thromboembolism in patients with cancer.
PG  - 24-29.e1
LID - 10.3821/1913-701X-145.1.24 [doi]
AB  - BACKGROUND: Many patients who experience a venous thromboembolic event have 
      cancer, and thrombosis is much more prevalent in patients with cancer than in 
      those without it. Thrombosis is the second most common cause of death in cancer 
      patients and cancer is associated with a high rate of recurrence of venous 
      thromboembolism (VTE), bleeding, requirement for long-term anticoagulation and 
      poorer quality of life. METHODS: A literature review was conducted to identify 
      guidelines and evidence pertaining to anticoagulation prophylaxis and treatment 
      for patients with cancer, with the goal of identifying opportunities for 
      pharmacists to advocate for and become more involved in the care of this 
      population. RESULTS: Many clinical trials and several guidelines providing 
      guidance to clinicians in the treatment and prevention of VTE in patients with 
      cancer were identified. Current clinical evidence and guidelines suggest that 
      cancer patients receiving care in hospital with no contraindications should 
      receive VTE prophylaxis with unfractionated heparin (UFH), a low-molecular-weight 
      heparin (LMWH) or fondaparinux. Patients who require surgery for their cancer 
      should receive prophylaxis with UFH, LMWH or fondaparinux. Cancer patients who 
      have experienced a VTE event should receive prolonged anticoagulant therapy with 
      LMWH (at least 3 months to 6 months). No routine prophylaxis is required for the 
      majority of ambulatory patients with cancer who have not experienced a VTE event. 
      Most publicly funded drug plans in Canada have developed criteria for funding of 
      LMWH therapy for patients with cancer. CONCLUSIONS: Evidence suggests that LMWH 
      for 3 to 6 months is the preferred strategy for most cancer patients who have 
      experienced a thromboembolic event and for hospital inpatients, but this is often 
      not implemented in practice. Concerns about adherence with injectable therapy 
      should not prevent use of these agents. Pharmacists should assess cancer patients 
      for their risk of VTE and should advocate for optimal VTE pharmacotherapy as 
      appropriate. If LMWH is the preferred agent, on the basis of the evidence, the 
      pharmacist should educate the patients appropriately and work with the prescriber 
      to ensure best care.
FAU - Semchuk, William M
AU  - Semchuk WM
FAU - Sperlich, Catherine
AU  - Sperlich C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Can Pharm J (Ott)
JT  - Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC
JID - 101257110
PMC - PMC3567538
EDAT- 2012/01/01 00:00
MHDA- 2012/01/01 00:01
PMCR- 2012/01/01
CRDT- 2013/03/20 06:00
PHST- 2013/03/20 06:00 [entrez]
PHST- 2012/01/01 00:00 [pubmed]
PHST- 2012/01/01 00:01 [medline]
PHST- 2012/01/01 00:00 [pmc-release]
AID - 10.3821/1913-701X-145.1.24 [doi]
PST - ppublish
SO  - Can Pharm J (Ott). 2012 Jan;145(1):24-29.e1. doi: 10.3821/1913-701X-145.1.24.