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. 2025 Sep:253:109399.
doi: 10.1016/j.thromres.2025.109399. Epub 2025 Jul 6.

"Who am I to say that I'm not going to take it": patient perspectives on decisions about antithrombotic therapy in the context of advanced cancer

Elin Baddeley  1 , Carme Font  2 , Isabelle Mahé  3 , Michelle Edwards  4 , Stephanie Sivell  4 , Kate J Lifford  5 , Victoria Mailen Arfuch  6 , Nuri Coma-Auli  2 , Mette Søgaard  7 , Helle Enggaard  8 , Hélène Helfer  3 , Nassima Si Mohammed  9 , Kathy Seddon  4 , Mark Pearson  10 , Simone P Mooijaart  11 , Sebastian Szmit  12 , F A Klok  13 , Simon Noble  4 , Anette Arbjerg Højen  14 ; SERENITY consortium
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Free article

"Who am I to say that I'm not going to take it": patient perspectives on decisions about antithrombotic therapy in the context of advanced cancer

Elin Baddeley et al. Thromb Res. 2025 Sep.
Free article

Abstract

Introduction: The decision to reconsider antithrombotic therapy (ATT) in cancer patients nearing the end of life is complex given the increasing risk of haemorrhage and thrombosis. A decision support tool (DST) is being developed to facilitate this process. Understanding patients' experiences, values, and perspectives are an essential component, yet remain largely unexplored.

Aim: To explore these patients' experiences, values and perspectives regarding ATT use.

Methods: Qualitative study using semi-structured interviews with patients with advanced cancer receiving ATT, across Denmark, France, Spain, and the United Kingdom. Data were analysed using Framework Analysis.

Results: Sixty patients and 13 relatives participated. Three major themes were generated: CONCLUSION: Patients found decision-making around ATT near the end of life multifaceted, occurring amid a myriad of competing priorities. While patients reported a reticence to discontinuing, ultimately many deferred such decisions to a clinician, whose role was highly valued. These findings support a need for a DST, to support informed and shared choices in ATT decisions.

Keywords: Antithrombotic therapy; Cancer; Patient experience; Qualitative research; Thrombosis.

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Conflict of interest statement

Declaration of competing interest EB, NCA, ME, HE, CF, HH, KL, IM, VMA, MP, SPM, KS, SS, MS, NSM, SS declare they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. FAK reports grants or contracts from Bayer, Bristol Myers Squibb, British Society of Cardiovascular Imaging, Merck Sharp & Dohme, LEO-Pharma, Actelion, Varm-X, The Netherlands Organisation for Health Research and Development, the Dutch Thrombosis Association, the Dutch Heart Foundation, and the Horizon Europe Program, all unrelated to this work and paid to his institution. SN reports research grant support from Leo Pharma, unrelated to this work and paid to his institution. AAH has received research grants from The Danish Heart Foundation and The Novo Nordisk Foundation, has been on the speaker bureaus for Bayer, and Bristol Myers Squibb, all of which are unrelated to this work and paid to her institution.

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