Background: The management of anticoagulation initiation, maintenance and completion is contextual in practice. Various factors can influence the appropriate anticoagulant, as well as the overall duration. When these factors are not truly appreciated, practitioners may provide unnecessary treatment which exposes patients to undue risk. Further, the implication of incorrectly interpreted thrombophilia testing may unnecessarily place patients on extended anticoagulation.
Aims: This study aims to determine if there was an identifiable knowledge gap between practitioners of varying degrees, specialties, or experience of practice, as it relates to the appropriateness of thrombophilia evaluation and anticoagulation management.
Methods: A total of 438 physicians and advanced practice providers (APPs) were surveyed with a questionnaire composed of both subjective and objective items related to their knowledge and practice experience with anticoagulation and thrombophilia. 404 of the 438 surveys were fully completed and analyzed using a combination of chi-square, Kruskal-Wallis with post-Hoc Dunn test, unpaired T-test and test item analysis where appropriate.
Results: The overall median physician score of 61.3% was significantly higher compared to APPs score of 52.4% (p = <0.001). Between specialties for the physicians, the Hospitalist and cardiology sub-groups had significantly higher median score compared to various medical specialties (table 1). The knowledge differential between physician and APP was not significant at 0-3 years of experience but was present at > 4 years of experience (p = <0.05).
Physician Vs APP Total Score
Scores of Physician Respondents based on Specialty
Conclusions: Our study shows a significant knowledge gap between providers of varying degrees and providers within different subspecialties. This may allow for a specific target audience for increased education regarding aspects of anticoagulation management and thrombophilia evaluation in the future.
To cite this abstract in AMA style:
Johnson T, Forman D. Appropriateness of Thrombophilia Evaluation and Anticoagulation Management: A Multi-specialty Survey of Practitioners at Tower Health Reading Hospital [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/appropriateness-of-thrombophilia-evaluation-and-anticoagulation-management-a-multi-specialty-survey-of-practitioners-at-tower-health-reading-hospital/. Accessed September 22, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/appropriateness-of-thrombophilia-evaluation-and-anticoagulation-management-a-multi-specialty-survey-of-practitioners-at-tower-health-reading-hospital/