Factors in Initial Anticoagulation Choice in Hospitalized Patients With Pulmonary Embolism
2025

Factors in Anticoagulation Choice in Pulmonary Embolism

Sample size: 46 publication Evidence: moderate

Author Information

Author(s): Stubblefield William B. MD MPH, Helderman Ron MD, Strokes Natalie DO MPH MS, Greineder Colin F. MD PhD, Barnes Geoffrey D. MD MsC, Vinson David R. MD, Westafer Lauren M. DO MPH MS

Primary Institution: Vanderbilt University Medical Center

Hypothesis

What are factors associated with initial anticoagulation choice in hospitalized patients with acute pulmonary embolism (PE)?

Conclusion

Physicians reported common barriers and facilitators to the use of guideline-concordant anticoagulation in patients hospitalized with acute PE.

Supporting Evidence

  • Physicians expressed agnosticism regarding anticoagulant choice.
  • Barriers included inertia of learned practice and therapeutic momentum.
  • Participants reported institutional culture influenced their anticoagulation strategies.

Takeaway

Doctors often don't care which blood thinner they use for patients with a lung clot, and they stick to what they learned in training instead of following the best guidelines.

Methodology

This qualitative study conducted semistructured interviews with physicians to assess factors influencing anticoagulation choice.

Potential Biases

Potential social desirability bias may have influenced participant responses.

Limitations

The study's qualitative nature limits generalizability, and participants may have provided socially desirable responses.

Participant Demographics

Of the 46 interviewees, 33 were men (71.7%) and 13 were women (28.3%), with a median age of 43 years.

Digital Object Identifier (DOI)

10.1001/jamanetworkopen.2024.52877

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