Physicians' perceptions of risks and practices in venous thromboembolism prophylaxis in inflammatory bowel disease

Hospitalized inflammatory bowel disease (IBD) patients are at a higher risk of venous thromboembolism (VTE).

We aimed to determine perceptions of VTE risks and self-reported practices regarding VTE prophylaxis in hospitalized IBD patients among American gastroenterologists.

Gastroenterologists who were members of the American Gastroenterological Association (AGA) and cared for IBD patients in the preceding 12 months were included. A survey assessed physicians' perceptions of VTE risks and their practices regarding VTE prophylaxis among IBD inpatients and other factors that may influence the decision to provide prophylaxis.

A total of 135 eligible gastroenterologists responded to the survey, 77 % of whom practiced in academic settings. Most physicians (84%) reported having had IBD patients develop VTE. Only 67% cared for IBD patients in hospitals that had protocols for VTE prophylaxis, and 45% were aware of any published guidelines for VTE prophylaxis in hospitalized IBD patients. While only 7% believed that any rectal bleeding was a contraindication to VTE chemoprophylaxis in hospitalized IBD patients with flares, 14% never administered prophylaxis to IBD inpatients. A significant number of respondents felt that hospitalized IBD patients who were ambulatory (24%) or in remission (28%) did not require VTE prophylaxis. There was wide variation on recommendations for duration of anticoagulation for a first unprovoked VTE in an IBD patient.

There is significant variation in reported practices for VTE prophylaxis in IBD patients among gastroenterologists. A more standardized approach to VTE prophylaxis should be implemented to improve health outcomes for IBD inpatients.