Quality statement 8: Follow‑up for people without cancer

Quality statement

People without cancer who receive anticoagulation therapy have a review within 3 months of diagnosis of confirmed proximal deep vein thrombosis or pulmonary embolism to discuss the risks and benefits of continuing anticoagulation therapy.

Rationale

As anticoagulation therapy carries potential risks such as bleeding there is a need to ensure the therapy remains beneficial. For people who have had a confirmed proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) and who do not have cancer, a review should take place.

Quality measure

Structure: Evidence of local arrangements to ensure people without cancer who have had a confirmed proximal DVT or PE and receive anticoagulation receive a review within 3 months of diagnosis to discuss the risks and benefits of continuing anticoagulation therapy.

Process: The proportion of people without cancer who have had a confirmed proximal DVT or PE and receive anticoagulation therapy who have a review within 3 months of diagnosis to discuss the risks and benefits of continuing anticoagulation therapy.

Numerator – the number of people in the denominator who receive a review within 3 months of diagnosis to discuss the risks and benefits of continuing anticoagulation therapy.

Denominator – the number of people who have received anticoagulation therapy following a confirmed diagnosis of proximal DVT or PE at least 3 months previously and who do not have cancer.

What the quality statement means for each audience

Service providers ensure systems are in place for people without cancer who have had a confirmed proximal DVT or PE and receive anticoagulation therapy to be offered a review within 3 months of diagnosis to discuss the risks and benefits of continuing anticoagulation therapy beyond 3 months.

Healthcare professionals ensure people without cancer who have had a confirmed proximal DVT or PE and receive anticoagulation therapy are offered a review within 3 months of diagnosis to discuss the risks and benefits of continuing anticoagulation therapy.

Commissioners ensure they commission services that offer people without cancer who have had a confirmed proximal DVT or PE and receive anticoagulation therapy a review within 3 months of diagnosis to discuss the risks and benefits of continuing anticoagulation therapy.

People without cancer who have had deep vein thrombosis or pulmonary embolism and who are having treatment with an anticoagulant (a drug that helps stop blood clots forming or enlarging and makes it less likely that a blood clot will come loose and travel to the lungs) are offered a review within 3 months of diagnosis to discuss the risks and benefits of continuing treatment with an anticoagulant.

Source guidance

NICE guideline CG144 recommendation 1.2.3.

NICE technology appraisal guidance 261.

Data source

Structure: Local data collection.

Process: Local data collection. Contained within NICE guideline CG144 clinical audit tools (treatment of venous thromboembolism and investigations for cancer), standard 3d.

Definitions

Timing of review: Healthcare professionals need to consider the summary of product characteristics to determine the timing of the review and duration of treatment required for the anticoagulant received.

Proximal DVT: DVT in the popliteal vein or above; proximal DVT in this context refers to 'above‑knee DVT'.