Thrombus - 2016

Effects of venous thromboembolism on health-related quality of life
Gemma Nicholl
pp 1-4
Venous thromboembolism (VTE) is an umbrella term used to describe deep vein thrombosis (DVT) and pulmonary embolism (PE). Besides the risk of PE, DVT is associated with post-thrombotic syndrome, which has a major impact on patients’ lives, as the effects of DVT can still be experienced even after successful treatment. VTE diagnosis can affect patients’ health-related quality of life (QoL), which then has a direct impact on their psychosocial wellbeing. VTE is a common illness that has been shown to have a high impact on morbidity, mortality, costs of care and QoL. Although QoL is important when assessing the progression of a disease, there has been little research into the outcomes of care in patients with VTE.

Comment: History repeating itself
Peter Rose
pp 2-2
The first edition of Thrombus was published in September 1997, with the aim to provide clinicians a readable and easily digestible update in the field of thrombosis and anticoagulation. Twenty years on, the aims remain much the same, with the journal having a wide appeal, particularly in the fields of haematology, cardiology, respiratory medicine, as well as in primary care. Since its inception, the journal has focused on providing a multidisciplinary view, with input from medical staff, nurse specialists and pharmacists. We welcome Dr Khalid Khan, Cardiologist, to the editorial board and hope to cover more aspects of anticoagulation in the field of cardiology, particularly with the emergence of the direct oral anticoagulants.

Clot slot

pp 5-5
The next CLOT conference will be held on Friday 14 October in Birmingham. We invite our members to suggest any topics they wish to be covered. If you would like to present your research or practice, please contact us via our website.

Improving efficiency in anticoagulation data collection and communication between primary and secondary care
Alex Kimber and Tamara Everington
pp 6-8
In the ever-changing NHS, the need to adapt to meet technological advances is becoming more relevant as services come under increasing pressure. Many hospitals are now adopting a paperless or ‘paperlite’ environment, and we were keen to develop this in the Anticoagulation and Thrombosis Department at Hampshire Hospitals NHS Foundation Trust. The team still had many paper processes, including high international normalised ratio records, and assessment and treatment plans for atrial fibrillation and venous thromboembolism patients. These paper-based processes impact on communication and effective collaboration between primary and secondary care services.

Resources: NCAT

pp 9-9
The National Centre for Anticoagulation Training (NCAT) is based in the Department of Primary Care Clinical Sciences at the University of Birmingham. We provide a wide range of courses to meet the educational needs of all healthcare professionals. Our palate of courses has been driven by demand from our delegates and has now extended to training courses including Respiratory Disease, Management of Headaches & Management of Neurological Disorders, Atrial Fibrillation and Stroke Prevention Management and Gynaecology. Our courses are delivered by leading national figures with lectures based on up-to-theminute information. Please see our website for further details.

QIC

pp 9-9

Abstract watch: Thrombosis and anticoagulation
Peter Rose
pp 10-11
In this new column, we feature a collection of abstracts that highlight some of the new research in the field of thrombosis, anticoagulation and clotting disorders. Research into this field is diverse and rapidly expanding, and we will endeavour to give you a sample of new findings and trends. We have collated abstracts from a number of peer-reviewed journals. Links to the full articles are provided, although you may need a subscription access to view them.

FAQ: How should I advise an anticoagulated patient getting a tattoo?
Suzanne Docherty
pp 12-12
Tattoos have undergone a considerable image change in recent years, having become a mainstream fashion accessory. According to a 2015 survey,19% of UK adults now have a tattoo; 30% are between 25 and 39 years of age, while only 9% are over 60. In 2013, around 2.4% of the English population was receiving anticoagulation treatment. The upsurge in tattoo popularity across age groups in recent years means that tattooed and anti coagulated populations increasingly overlap.

How do we engage junior doctors to improve safety of inpatient warfarin prescribing?
Janine L Wright
pp 13-15
Medication errors are the single most preventable cause of patient harm. Warfarin is a high-risk medication but is used safely in the majority of cases. Its dose requires adjustment according to blood monitoring of the international normalised ratio (INR). If the INR strays too far from the therapeutic range, there is a risk of patient harm – if it falls below the therapeutic range, the patient is at risk of the very pathology that warfarin treatment is intended to prevent; if it is too high, the patient may experience uncontrollable bleeding. However, when a patient’s INR deviates from the therapeutic range, they will usually be symptomless and changes are only detectable through blood tests. The first symptom of INR being out of the range may be a catastrophic event, such as uncontrolled bleeding or a stroke, and preventing these requires regular blood testing and appropriate warfarin dosing adjustment.

Thrombus was previously supported by Bayer from 2014 to 2016, by Boehringer Ingelheim from 2009 to 2013, by sanofi-aventis from 2007 to 2008 and by Leo Pharma from 1998 to 2006.

The data, opinions and statements appearing in the articles herein are those of the contributor(s) concerned; they are not necessarily endorsed by the sponsor, publisher, Editor or Editorial Board. Accordingly the sponsor, publisher, Editor and Editorial Board and their respective employees, officers and agents accept no liability for the consequences of any such inaccurate or misleading data, opinion or statement.

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ISSN 1369-8117 (Print) ISSN 2045-7855 (Online)