Towards optimal use of antithrombotic therapy of people with cancer at the end of life: A research protocol for the development and implementation of the SERENITY shared decision support tool.

BACKGROUND

Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs.

METHODS

The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe.

RESULTS

SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life.

CONCLUSIONS

We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers.

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest AAH reports grants, speaking, or consulting fees from Bayer, MSD, LEO-Pharma and Bristol-Myers Squibb/Pfizer. MS reports grants and consulting fees from Bayer. JJB is a speaker for Abbott and Edwards Lifesciences. GJG is vice-chair of the Dutch Federation of Thrombosis services, and reports grants from Bayer, BMS, Pfizer and Daiichi-Sankyo, The Dutch Research Council, The Netherlands Organisation for Health Research and Development, and the Dutch Heart Foundation, all unrelated to this work and paid to his institution. MVH reports grants from Dutch Heart Foundation, ZonMw, Bayer Health Care, Pfizer-BMS, and Leo Pharma, all unrelated to this work. FAK reports grants or contracts from Bayer, BMS, BSCI, MSD, 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. AM reports advisory board honoraria from Bayer, BMS Sanofi and Pfizer, speaker's bureau for BMS and Bayer and an educational grant from Bayer. DM reports contracts from BMS, Leo Pharma, Pfizer and Sanofi. MJHAK reports grants from Sobi, The Netherlands Organisation for Health Research and Development and the Dutch Thrombosis Association and speakers fee from Roche, Sobi and BMS, all unrelated to this work and paid to his institution. FEMM reports grants from Yorkshire Cancer Research, Marie Curie Cancer Care, the UK National Institute of Health and Care Research, and Hull Clinical Commissioning Group, all unrelated to this work. LV reports a grant from the Dutch Cancer Society, the Netherlands Organization for Health Service Research and Development, and the Dutch Research Council, all unrelated to this work. All others report no conflicts of interest related to this project.