Attitudes towards and practice of venous thromboembolism prevention in general internal medicine wards A multinational survey from member countries of the European Federation of Internal Medicine

Introduction: Hospitalised patients in Internal Medicine departments are at risk of venous thromboembolism (VTE). Adherence to risk stratification methods is poor. We conducted a survey among Internists from member countries of the European Federation of Internal Medicine (EFIM) to assess current knowledge and attitude towards VTE prevention. Methods: A multinational survey of Internists affiliated to EFIM. Results: 226 physicians from 30 countries were included. Seventy nine percent of the physicians were aware of clinical guidelines to prevent VTE. Most considered their knowledge of the guidelines to be moderate. Many had not updated their knowledge recently. The magnitude of the clinical problem was over-and underestimated by many (12.2% and 40.1%, respectively). Only 46.7% thought their patients were mostly receiving proper prophylaxis. Sixty four percent worked in departments without a formal VTE prophylaxis program. Risk of bleeding, lack of awareness and lack of decision support systems were the three most common reasons for deferring treatment (88.6%, 32.3% and 27.9%, respectively). Most of the participants stated that they strongly believe in VTE prophylaxis as an intervention that prevents morbidity and mortality. Conclusions: Despite general awareness of clinical guidelines, many medical wards do not have formal risk assessment methodologies incorporated into their operative workflow. This gap, as well as fear of complications, may be one of the reasons for the low rates of adherence reported by physicians. We speculate that perhaps current guidelines have not been accepted by Internists due to paucity of well defined and validated risk assessment tools. (C) 2011 Elsevier Ltd. All rights reserved.