This study evaluates the use of extended venous thromboembolism prophylaxis (ePPx) following abdominopelvic cancer surgery within the NCI Community Oncology Research Program (NCORP) network, targeting surgeons and surgical advanced practice providers (APPs).
PRIMARY OBJECTIVE: I. To evaluate self-reported utilization of guideline concordant extended venous thromboembolism (VTE) prophylaxis (ePPx) following abdominopelvic cancer surgery within a sample of surgeons practicing within NCORP based on the Part 1 surgeon survey. SECONDARY OBJECTIVES: I. Evaluate site factors (e.g., proportion of publicly insured patients, proportion of Black patients, presence of a medical school, NCI designation) and surgeon factors (e.g., fellowship training, years in practice) associated with surgeon self-reported guideline concordant ePPx utilization (Part 1). II. Conduct semi-structured interviews among a subset of surgeons and surgical APPs to assess: 1) Barriers/facilitators toward ePPx after cancer surgery and 2) Acceptability of clinical decision support tools to support VTE prophylaxis prescribing (Part 2). III. Extract EHR data from select practices to assess the feasibility of query-based electronic health record (EHR) data extraction for identification of (i) patients undergoing cancer surgery, and (ii) prescription of guideline concordant ePPx among eligible patients (Part 3). OUTLINE: This is an observational study. PART 1: Surgeons and APPs complete a survey on study. After completion of surgeon or APP survey, site contact person or Cancer Care Delivery Research (CCDR) lead complete site surveys on study. PART 2: A subset of surgeons and APPs from part 1 complete a semi-structured interview on study. PART 3: Site contact person or CCDR lead complete a survey to identify a EHR Report Specialist on study. EHR Report Specialist performs an EHR Data Extraction and provides feedback on the process in a survey.
Study Type
OBSERVATIONAL
Enrollment
500
Non-interventional study
Non-interventional study
Non-interventional study
Self-reported utilization of guideline concordant ePPx for surgeons (Part 1)
Will apply only to surgeons completing the Part 1 survey. Will be defined as answering "Yes, all cases or almost all cases" on the survey question asking about prescription of ePPx after discharge. The proportion of surgeons self-reporting utilization of guideline concordant ePPx will be estimated and reported along with an exact 95% confidence interval.
Time frame: After 1 year from start of Part 1
Self-reported utilization of guideline concordant ePPx for surgeons within strata defined by site and surgeon factors (Part 1)
Self reported utilization as defined above for the primary outcome measure will be reported within strata defined by: * Site factors (e.g., proportion of publicly insured patients, proportion of Black patients, presence of a medical school, NCI designation) * Surgeon factors (e.g., fellowship training, years in practice)
Time frame: After 1 year from start of Part 1
Barriers and facilitators toward ePPx after cancer surgery, and acceptability of clinical decision support tools to support VTE prophylaxis prescribing (Part 2)
Themes from qualitative interviews by surgeons and APPs
Time frame: After 6 months from start of Part 2
Feasibility (i.e., proportion of practices able to provide data) of EHR queries from selected practices to inform future trial (Part 3)
Considered feasible if at least 4 of the 6 practices who agreed to participate are able to provide data on both patients undergoing cancer surgery and prescription of guideline concordant ePPx among eligible patients
Time frame: After 6 months from start of Part 3
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