Perception and practice of thromboprophylaxis in patients with hematological malignancies among hemato-oncology practitioners in Nigeria

Abstract

Background: Cancer-associated thrombosis is a cause of increased morbidity and mortality in patients with hematological malignancies. Thromboprophylaxis may reduce this risk and improve the patients' prognosis and quality of life. Objectives: The study evaluates the awareness and practice of thromboprophylaxis by physicians managing patients with hematological malignancies and identifies challenges with such practice. Subjects and Methods: This descriptive cross-sectional study was conducted during the 42nd Annual General Meetings of the Nigerian Society of Haematology and Blood Transfusion held in Lagos 2016. A 12-item pretested questionnaire was used to obtain data on the perception and practice of thromboprophylaxis of hemato-oncologic patients from the 55 consenting hematologists in attendance. Data were analyzed with SPSS version 21. Results: The awareness and practice rate of cancer thromboprophylaxis are 96.4% and 92.7%, respectively. Multiple myeloma is the most common neoplasm of which hematologists practice thromboprophylaxis. Warfarin is the most prescribed anticoagulant. Doppler ultrasonography and basic coagulation screening tests are most readily available investigations. Funding and laboratory insufficiency are the leading challenges mitigating against effective management of venous thromboembolism (VTE). Conclusion: There is a high level of awareness and practice of thromboprophylaxis in cancer patients by Nigerian hematologists; however, scarcity of fund for investigation and drug procurement and limited laboratory capacity to diagnose and monitor patients still constitute a challenge to effective management of VTE.