Patient education program at the forefront of cancer-associated thrombosis care - 25/08/21

Doi : 10.1016/j.jdmv.2021.08.001

M. Sebuhyan ^a,^b,^⁎ , B. Crichi ^a,^c, L. Deville ^d, C. Le Maignan ^a,^c, C. Bonnet ^e, Z. Marjanovic ^a,^f, J. Rueda ^a,^g, O. Bensaoula ^a,^h, A. Ndour ^a,^c, C. Frere ^a,ⁱ, I. Madeleine ^d, D. Farge ^a,^c,^j,⁎
^a Groupe francophone thrombose et cancer, Paris, France
^b Department of Clinical Physiology, Lariboisière Hospital, AP–HP, Paris, France
^c Department of Internal Medicine (UF 04), CRMR MATHEC, maladies auto-immunes et thérapie cellulaire, Saint-Louis Hospital, AP–HP, Paris, France
^d Pharmacy Department, Saint-Louis Hospital, AP–HP, Paris, France
^e Department of Medical Oncology, Saint-Louis Hospital, AP–HP, Paris, France
^f Department of Hematology, Saint-Antoine Hospital, AP–HP, Paris, France
^g Department of Internal Medicine, Hospital Universitario Rey-Juan-Carlos, Madrid, Spain
^h Department of Medical Oncology CLCC Curie Institute, centre Rene-Huguenin, Saint Cloud, France
ⁱ Inserm UMRS_1166, Department of Hematology, Institute of Cardiometabolism And Nutrition, GRC 27 GRECO, Pitié-Salpêtrière Hospital, Sorbonne université, AP–HP, Paris, France
^j EA 3518, institut universitaire d’hématologie, université de Paris, Paris, France

^⁎Corresponding author.^⁎⁎Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 25 August 2021
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Summary

Introduction

Treatment of cancer-associated thrombosis (CAT) requires specific approaches, although it is well codified in most cases. Current national and international (International Initiative on Cancer and Thrombosis, ITAC) Clinical Practice Guidelines (CPG) recommend the use of low-molecular-weight heparin (LMWH) over 6 months as first treatment option, and anticoagulation should be maintained thereafter as long as cancer is active. Since compliance improves when patients understand their disease and related treatments, we created a dedicated patient education program (PEP) for CAT, aiming to improve quality of care.

Methods

Retrospective analysis of all patients who voluntarily joined the PEP for CAT from 2014 to 2020.

Results

In total, 182 cancer patients (median age, 64.9 years) were included, 53.3% with metastatic disease. A total of 528 PEP sessions (median, 3 per patient) were delivered. After PEP completion, the rate of self-injections or those performed at home by a relative had increased from 49.1% to 59.8% (P=0.05). Quality of life had improved significantly (P=0.025) and 90.0% of patients reported adhering to anticoagulant therapy.

Conclusion

Implementation of a structured and personalized PEP for CAT is feasible, allowing to improve cancer patient empowerment, adherence to CAT treatment and quality of life. The Groupe francophone et cancer (GFTC) members aim at facilitating access to CAT-PEP for both patients and caregivers and use of the multi-language ITAC-CPG mobile app (free access: www.itaccme.com/) to improve the care and quality of life of patients with CAT.

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Keywords : Cancer-associated thrombosis, Clinical practice guidelines, Anticoagulant, Patient education program, Multidisciplinary care program, Quality of care, Quality of life