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Adherence to thrombophilia testing guidelines and its influence on anticoagulation therapy: A single-center

Kristina Vrotniakaite-Bajerciene1, Tobias Tritschler2, Katarzyna Aleksandra Jalowiec1

  • 1Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department for BioMedical Research, University of Bern, Switzerland.

Thrombosis Research
|February 1, 2023
PubMed

Insights

Adherence to thrombophilia testing guidelines was low, and test results rarely influenced treatment decisions. Improving patient selection criteria is crucial for enhancing the therapeutic impact of thrombophilia testing.

Area of Science:

  • Hematology
  • Clinical Medicine
  • Medical Diagnostics

Background:

  • Limited evidence exists on thrombophilia guideline adherence.
  • The impact of thrombophilia testing on clinical decisions remains largely unknown.
  • Current guidelines for thrombophilia testing require investigation regarding their real-world application.

Purpose of the Study:

  • To investigate adherence to thrombophilia testing guidelines.
  • To assess the therapeutic impact of guideline-adherent versus non-adherent testing.
  • To identify patient characteristics influencing treatment decisions based on thrombophilia tests.

Main Methods:

  • A single-center, cross-sectional study of 3686 patients referred for thrombophilia testing (2010-2020).
  • Systematic evaluation of adherence to internal thrombophilia testing guidelines.
  • Multivariable logistic regression to analyze the influence of test results on anticoagulation therapy.

Main Results:

  • Only 33% of thrombophilia testing indications adhered to guidelines.
  • Test results influenced treatment in 5.1% of guideline-adherent cases versus 9.7% of non-adherent cases.
  • Factors associated with treatment influence included younger age, female sex, and specific thromboembolism types.

Conclusions:

  • Poor adherence to thrombophilia testing guidelines was observed.
  • Thrombophilia testing adherence did not significantly impact treatment decisions.
  • Refining patient selection criteria is necessary to enhance the clinical utility of thrombophilia testing.
Abstract

Keywords:
Antiphospholipid syndromeClinical-decision makingGuideline adherenceThrombophiliaVenous thromboembolism

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