Open AccessPatient Experience of Living With Cancer‐Associated Thrombosis in Canada (PELICANADA)
Author(s) -
Noble Simon,
Nelson Annmarie,
Scott Jill,
Berger Anne,
Schmidt Karen,
Swarnkar Parinita,
Lee Agnes
Publication year - 2020
Publication title -
research and practice in thrombosis and haemostasis
Language(s) - English
Resource type - Journals
ISSN - 2475-0379
DOI - 10.1002/rth2.12274
Subject(s) - medicine , cancer , thrombosis , thrombus , nonprobability sampling , distress , thematic analysis , warfarin , low molecular weight heparin , family medicine , medical emergency , qualitative research , surgery , population , clinical psychology , environmental health , social science , sociology , atrial fibrillation
Previous research from the United Kingdom and Spain has identified several areas of unmet clinical and support need for cancer patients diagnosed with venous thromboembolism. It is not known whether such experiences are restricted to those countries health care systems and culture. We therefore evaluated patients’ experience of cancer‐associated thrombosis (CAT) within a Canadian setting. Methods Purposive sampling of patients with CAT attending a regional thrombosis clinic in Vancouver was undertaken. Semistructured interviews were audio recorded, transcribed, and coded using NVivo software. A deductive approach was taken by applying the framework matrix from the original study to these data on a case‐by‐case basis. Results Twenty patients (10 male, 10 female) aged 39 to 74 (mean, 63) representing a breadth of different cancers participated. Commonalities between the UK and Canadian patients included the traumatic nature of experiencing CAT, the need for information, and adaptive behaviors through ritualization. Two new themes were identified: (1) Patients with incidental pulmonary emboli (iPE) were usually telephoned about their thrombus with little support and suboptimal communication; and (2) cost implications of accessing low‐molecular‐weight heparin varied according to insurance cover. Patients were sometimes converted to warfarin for financial reasons. Conclusion The distress associated with CAT is a common experience across different populations but may be ameliorated by early access to specialist services, information, and support. The current process for managing iPE could be improved with better communication and a dedicated clinical pathway. Funding issues may influence choice of anticoagulant.