Nurse Consultant University Hospital Plymouth NHS trust Plymouth, England, United Kingdom
Background: We have collected data on all venous thrombosis (VTE) events over many years and have since 2019 also included information on the type of anticoagulant used.
Aims: To identify any changes over the study period in the anticoagulant medications used considering this period covers COVID 19. We also were interested in looking at the use of low molecular weight heparin (LMWH) over the study and the major reasons that this was used.
Methods: Information on all VTE cases was collected using the radiology system then patient discharge and management systems were utilised to identify medication used. We followed up at hospital discharge as many patients were initially commenced on LMWH but switched to a direct oral anticoagulant (DOAC) prior to discharge. For patients discharged on LMWH whether they have a diagnosis of active cancer, were pregnant, breastfeeding, or post-partum (PBFPP)was also collected.
Results: In 2019 there were 703 VTE cases with DOAC used in 564 cases (80%) and LMWH in 59 cases (8%) with 43 being cancer patients and 10 PBFPP. By 2023 there were 810 cases with 678 (84%) using a DOAC and LMWH used in 57 cases (7%) comprising 29 cancer patients and 14 PBFPP. Over the study period there has been relatively little change in medications used as shown in table 1 with warfarin for example being between 17 -33 cases annually.
Conclusion(s): Due to the time frame studied DOAC use was already established there is little change seen in the medications used. In 2021 with covid 19 at its peak we saw a increase in total VTE being 938 cases but DOAC use still around 80% though there was an increase in patients on no treatment associated with COVID mortality. The trials in cancer have led to an increase in DOAC use but perhaps not as large as expected.
