The main objective of the study is to develop or validate a clinical prediction rule for major bleeding in patients on oral anticoagulant therapy who have been safely anticoagulated without bleeding or venous thromboembolism (VTE) recurrence for at least 3 months since diagnosis and are being considered for long-term oral anticoagulant therapy.
Oral anticoagulant therapy for patients who are at risk of developing blood clotting problems is used by between 400,000-600,000 Canadians annually. The use of this drug represents the most common cause of patient adverse medical outcomes due to medical errors. Furthermore, many patients have adverse outcomes using these drugs because physicians are not able to predict which patients are likely to have bleeding outcomes. Much effort has gone into developing ways to predict which patients are at risk of clotting but almost no work has gone into ways of predicting which patients would be at high risk of bleeding. This information is required to balance off the risk-benefits and to enable physicians and patients to understand the risks and benefits of taking these medications. Our study will develop a tool that can be used to predict bleeding risk in patients taking oral anticoagulant therapy. It will enable more informed decision making by both physicians and patients and will result in better control of the use of these drugs. In addition, patients who are at risk for being difficult to accurately dose on oral anticoagulants will be identified through our study.
Study Type
OBSERVATIONAL
Enrollment
2,537
Lahey Clinic
Burlington, Massachusetts, United States
Henry Ford Health System
Detroit, Michigan, United States
Queen Elizabeth II Health Sciences Centre
Halifax, Nova Scotia, Canada
Major bleeding (International Society on Thrombosis and Haemostasis(ISTH) criteria)
Time frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals
Clinically relevant non-major bleeding (International Society on Thrombosis and Haemostasis(ISTH) criteria)
Time frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals
recurrent venous thromboembolism
Time frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals
death (all causes)
Time frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals
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Hamilton General Hospital
Hamilton, Ontario, Canada
Hamilton Health Sciences
Hamilton, Ontario, Canada
London Health Sciences Centre
London, Ontario, Canada
Ottawa Hospital Research Institute
Ottawa, Ontario, Canada
Montreal General Hospital
Montreal, Quebec, Canada
Sir Mortimer B Davis Jewish General Hospital
Montreal, Quebec, Canada
St. Mary's Hospital Centre
Montreal, Quebec, Canada
...and 2 more locations