Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 21;4(1):154-160.
doi: 10.1002/rth2.12274. eCollection 2020 Jan.

Patient Experience of Living With Cancer-Associated Thrombosis in Canada (PELICANADA)

Simon Noble  1 , Annmarie Nelson  1 , Jill Scott  2 , Anne Berger  2 , Karen Schmidt  2 , Parinita Swarnkar  1 , Agnes Lee  3
Affiliations

Patient Experience of Living With Cancer-Associated Thrombosis in Canada (PELICANADA)

Simon Noble et al. Res Pract Thromb Haemost. .

Abstract

Introduction: Previous research from the United Kingdom and Spain has identified several areas of unmet clinical and support need for cancer patients diagnosed with venous thromboembolism. It is not known whether such experiences are restricted to those countries health care systems and culture. We therefore evaluated patients' experience of cancer-associated thrombosis (CAT) within a Canadian setting.

Methods: Purposive sampling of patients with CAT attending a regional thrombosis clinic in Vancouver was undertaken. Semistructured interviews were audio recorded, transcribed, and coded using NVivo software. A deductive approach was taken by applying the framework matrix from the original study to these data on a case-by-case basis.

Results: Twenty patients (10 male, 10 female) aged 39 to 74 (mean, 63) representing a breadth of different cancers participated. Commonalities between the UK and Canadian patients included the traumatic nature of experiencing CAT, the need for information, and adaptive behaviors through ritualization. Two new themes were identified: (1) Patients with incidental pulmonary emboli (iPE) were usually telephoned about their thrombus with little support and suboptimal communication; and (2) cost implications of accessing low-molecular-weight heparin varied according to insurance cover. Patients were sometimes converted to warfarin for financial reasons.

Conclusion: The distress associated with CAT is a common experience across different populations but may be ameliorated by early access to specialist services, information, and support. The current process for managing iPE could be improved with better communication and a dedicated clinical pathway. Funding issues may influence choice of anticoagulant.

Keywords: cancer‐associated thrombosis; cultural; patient experience; qualitative; venous thromboembolism.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Previously identified themes and new themes
See this image and copyright information in PMC

References

    1. Timp JF, Braekkan SK, Versteeg HH, Cannegieter SC. Epidemiology of cancer‐associated venous thrombosis. Blood. 2013;122:1712–23. - PubMed
    1. Noble S, Pasi J. Epidemiology and pathophysiology of cancer‐associated thrombosis. Br J Cancer. 2010;102(Suppl 1):S2–9. - PMC - PubMed
    1. Noble S, Lewis R, Whithers J, Lewis S, Bennett P. Long‐term psychological consequences of symptomatic pulmonary embolism: a qualitative study. BMJ Open. 2014;4:e004561. - PMC - PubMed
    1. Bennett P, Patterson K, Noble S. Predicting post‐traumatic stress and health anxiety following a venous thrombotic embolism. J Health Psychol. 2016;21:863–71. - PubMed
    1. Hunter R, Lewis S, Noble S, Rance J, Bennett PD. "Post‐thrombotic panic syndrome": A thematic analysis of the experience of venous thromboembolism. Br J Health Psychol. 2017;22:8–25. - PubMed