Implementing a Clinical Decision Tool to Improve Oncologic Venous Thromboembolism Management

Area of Science:

• Oncology
• Hematology
• Medical Informatics

Background:

• Managing venous thromboembolic (VTE) disease in cancer patients requires complex decision-making regarding anticoagulation.
• Clinical decision support systems (CDTs) can integrate evidence-based guidelines at the point of care to aid clinicians.

Purpose of the Study:

• To develop, implement, and evaluate an electronic CDT for adult oncologic patients presenting with new VTE.
• The tool aims to support decision-making for anticoagulation management in symptom care clinics.

Main Methods:

• A pre-intervention group (n=98) was compared to two post-intervention groups: CDT applied (n=96) and not applied (n=46).
• Outcomes assessed included adherence to CDT anticoagulation recommendations and provider confidence/helpfulness of the tool.

Main Results:

• No significant difference was observed in the adherence to CDT recommendations between pre- and post-intervention groups (68.8% vs. 60.8% and 63.5%).
• The CDT was perceived as helpful and significantly improved provider confidence in initiating VTE management (p=0.033).

Conclusions:

• The developed CDT provides evidence-based anticoagulation recommendations for cancer-associated VTE, enhancing standard of care familiarity.
• Further refinement of the CDT is needed to address instances where recommendations were not followed.