The topic concerns some oncologists who are suggesting electronic alerts and other methods to increase compliance.

Venous thromboembolism is the second leading cause of death in patients with cancer, but compliance with routine prophylaxis remains a challenge.

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Studies continue to show that many at-risk patients with cancer are not receiving appropriate prophylaxis or any prophylaxis at all, even though many society guidelines call for routine prophylaxis. According to results from the Fundamental Research in Oncology and Thrombosis (FRONTLINE) survey published in 2003, just 52% of surgeons routinely used thromboprophylaxis for surgical patients with cancer, and routine prophylaxis was considered in less than 5% of medical oncology patients.

Alpesh Amin, MD, FACP, medical director of the anticoagulation clinic, University of California, Irvine, said there is a huge opportunity for improvement in thromboprophylaxis in patients with cancer.

Similarly, data presented this year at the ASCO Annual Meeting and published in the Journal of Clinical Oncology revealed that 75.3% of patients with cancer did not receive anticoagulation during their hospital stays. None of these patients, identified from the Premier Perspective database and the Ingenix LabRx I3 database, had contraindications for anticoagulation. Within 30 days after hospital discharge, 97.9% of patients did not receive any prophylaxis.

“Venous thromboembolism prevention in this at-risk population has significant opportunities for improvement,” said Alpesh Amin, MD, FACP, executive director of the hospitalist program and medical director of the anticoagulation clinic at the University of California, Irvine, and lead author of the study presented at ASCO. “Only about one-quarter of providers are actually prophylaxing patients, based on the American College of Chest Physicians guidelines. There is a huge opportunity to actually improve the prevention, and other national societies such as ASCO are also on board in terms of appropriate venous thromboembolism prevention.”