Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study

Introduction: To develop a European shared decision support tool (SDST), a Delphi process will be used to reach consensus about aspects relating to the continuation or deprescribing of antithrombotic therapy (ATT) in cancer patients at the end of life. As part of the SERENITY project, this study cor...

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Main Authors: Imene Deneche, Camille Couffignal, Nassima Si Mohammed, Anette Arbjerg Højen, Carme Font, Stavros Konstantinides, Marieke Kruip, Luigi Maiorana, Sebastian Szmit, Denise Abbel, Laurent Bertoletti, Susanne Cannegieter, Adrian Edwards, Michelle Edwards, Alessandra Gava, Jacobijn Gussekloo, Miriam J. Johnson, Rashmi Kumar, Johan Langendoen, Kate Lifford, Ellen Ligtenberg, Simon Mooijaart, Mark Pearson, Johanneke Portielje, Kathy Seddon, Stella Trompet, Frederikus A. Klok, Simon Noble, Isabelle Mahé
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Language:English
Published: Elsevier 2025-06-01
Series:Thrombosis Update
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666572725000124
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author Imene Deneche
Camille Couffignal
Nassima Si Mohammed
Anette Arbjerg Højen
Carme Font
Stavros Konstantinides
Marieke Kruip
Luigi Maiorana
Sebastian Szmit
Denise Abbel
Laurent Bertoletti
Susanne Cannegieter
Adrian Edwards
Michelle Edwards
Alessandra Gava
Jacobijn Gussekloo
Miriam J. Johnson
Rashmi Kumar
Johan Langendoen
Kate Lifford
Ellen Ligtenberg
Simon Mooijaart
Mark Pearson
Johanneke Portielje
Kathy Seddon
Stella Trompet
Frederikus A. Klok
Simon Noble
Isabelle Mahé
author_facet Imene Deneche
Camille Couffignal
Nassima Si Mohammed
Anette Arbjerg Højen
Carme Font
Stavros Konstantinides
Marieke Kruip
Luigi Maiorana
Sebastian Szmit
Denise Abbel
Laurent Bertoletti
Susanne Cannegieter
Adrian Edwards
Michelle Edwards
Alessandra Gava
Jacobijn Gussekloo
Miriam J. Johnson
Rashmi Kumar
Johan Langendoen
Kate Lifford
Ellen Ligtenberg
Simon Mooijaart
Mark Pearson
Johanneke Portielje
Kathy Seddon
Stella Trompet
Frederikus A. Klok
Simon Noble
Isabelle Mahé
author_sort Imene Deneche
collection DOAJ
description Introduction: To develop a European shared decision support tool (SDST), a Delphi process will be used to reach consensus about aspects relating to the continuation or deprescribing of antithrombotic therapy (ATT) in cancer patients at the end of life. As part of the SERENITY project, this study corresponds to work package (WP) 4. Methods: Findings from SERENITY WPs 1–3 (realist review, flash mob research, epidemiological and qualitative studies) informed the Delphi study. The WP4 steering committee had two objectives. (1) to build a representative expert panel comprising physicians, pharmacists, nurses and psychologists from eight European countries; and (2) to advise on the content of the Delphi form, divided into four sections: context, content, SDST design and trial outcomes. The form was reviewed by the SERENITY patient and public involvement group to ensure that it met patients’ needs. The Delphi study will take place in three rounds held at 6-week intervals, involving experts from eight countries. Consensus will be reached on items with at least 70 % agreement. The steering committee will review and validate the results across the different rounds. Results: Through this Delphi study, the following aspects will be defined: characterisation of candidate patients for discussion about ATT deprescribing; healthcare team roles in ATT decision-making; specific information and communication requirements for patients when making deprescribing decisions; SDST content priorities; and optimal outcomes for the planned clinical trial. Conclusion: This study will feed directly into the development and evaluation of the SDST, aimed at reducing complications and improving quality-of-life in end-of-life cancer patients receiving ATT.
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spelling doaj-art-908b23d880fd49dca98da654920deafe2025-08-20T02:35:50ZengElsevierThrombosis Update2666-57272025-06-011910020910.1016/j.tru.2025.100209Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi studyImene Deneche0Camille Couffignal1Nassima Si Mohammed2Anette Arbjerg Højen3Carme Font4Stavros Konstantinides5Marieke Kruip6Luigi Maiorana7Sebastian Szmit8Denise Abbel9Laurent Bertoletti10Susanne Cannegieter11Adrian Edwards12Michelle Edwards13Alessandra Gava14Jacobijn Gussekloo15Miriam J. Johnson16Rashmi Kumar17Johan Langendoen18Kate Lifford19Ellen Ligtenberg20Simon Mooijaart21Mark Pearson22Johanneke Portielje23Kathy Seddon24Stella Trompet25Frederikus A. Klok26Simon Noble27Isabelle Mahé28Department of Epidemiology, Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, FranceDepartment of Epidemiology, Biostatistics and Clinical Research, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, FranceClinical Research Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, FranceDanish Center for Health Services Research, Aalborg University Hospital and Aalborg University Aalborg, DenmarkMedical Oncology Department, Hospital Clinic de Barcelona, Barcelona, SpainCenter for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, GermanyDepartment of Hematology Erasmus MC, Erasmus University Medical Center, Rotterdam, the NetherlandsSocieta per l’Assistenza al Malato Oncologico Terminale Onlus (S.A.M.O.T.) Ragusa Onlus, Ragusa, ItalyDepartment of Cardio-Oncology, Centre of Postgraduate Medical Education, Warsaw, PolandDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the NetherlandsUniversité Jean Monnet Saint-Étienne, CHU Saint-Étienne, Mines Saint-Etienne, INSERM, SAINBIOSE U1059, CIC, 1408, Saint-Etienne, FranceDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the NetherlandsCardiff University, Department of Primary Care and Public Health, Cardiff, UKCardiff University, Department of Primary Care and Public Health, Cardiff, UKSocieta per l’Assistenza al Malato Oncologico Terminale Onlus (S.A.M.O.T.) Ragusa Onlus, Ragusa, ItalyDepartment of Medicine — Internal Medicine and Geriatrics, Leiden University Medical Center, Leiden, the NetherlandsWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UKCardiff University, Department of Primary Care and Public Health, Cardiff, UKTodayTomorrow, Rotterdam, the NetherlandsWales Centre for Primary and Emergency Care Research (PRIME Centre Wales), Division of Population Medicine, Cardiff University, Cardiff, UKDepartment of Hematology Erasmus MC, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the NetherlandsWolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UKDepartment of Medicine - Internal Medicine and Medical Oncology, Leiden University Medical Center, Leiden, the NetherlandsDivision of Population Medicine, Cardiff University, Cardiff, UKDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Medicine — Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the NetherlandsCardiff University, Cardiff, UKUniversité Paris Cité, APHP, Hôpital Louis Mourier, Service de Médecine Interne, Colombes, France; INNOVTE-FCRIN, France; Inserm UMR-S970, Paris Cardiovascular Research Center, Team « Endotheliopathy and Hemostasis Disorders », France; Corresponding author. Service de Médecine Interne, Hôpital Louis Mourier, AP-HP 178, Rue des Renouillers, 92700, Colombes, France.Introduction: To develop a European shared decision support tool (SDST), a Delphi process will be used to reach consensus about aspects relating to the continuation or deprescribing of antithrombotic therapy (ATT) in cancer patients at the end of life. As part of the SERENITY project, this study corresponds to work package (WP) 4. Methods: Findings from SERENITY WPs 1–3 (realist review, flash mob research, epidemiological and qualitative studies) informed the Delphi study. The WP4 steering committee had two objectives. (1) to build a representative expert panel comprising physicians, pharmacists, nurses and psychologists from eight European countries; and (2) to advise on the content of the Delphi form, divided into four sections: context, content, SDST design and trial outcomes. The form was reviewed by the SERENITY patient and public involvement group to ensure that it met patients’ needs. The Delphi study will take place in three rounds held at 6-week intervals, involving experts from eight countries. Consensus will be reached on items with at least 70 % agreement. The steering committee will review and validate the results across the different rounds. Results: Through this Delphi study, the following aspects will be defined: characterisation of candidate patients for discussion about ATT deprescribing; healthcare team roles in ATT decision-making; specific information and communication requirements for patients when making deprescribing decisions; SDST content priorities; and optimal outcomes for the planned clinical trial. Conclusion: This study will feed directly into the development and evaluation of the SDST, aimed at reducing complications and improving quality-of-life in end-of-life cancer patients receiving ATT.http://www.sciencedirect.com/science/article/pii/S2666572725000124Antithrombotic treatmentDeprescriptionCancerEnd of lifePalliative careDelphi consensus
spellingShingle Imene Deneche
Camille Couffignal
Nassima Si Mohammed
Anette Arbjerg Højen
Carme Font
Stavros Konstantinides
Marieke Kruip
Luigi Maiorana
Sebastian Szmit
Denise Abbel
Laurent Bertoletti
Susanne Cannegieter
Adrian Edwards
Michelle Edwards
Alessandra Gava
Jacobijn Gussekloo
Miriam J. Johnson
Rashmi Kumar
Johan Langendoen
Kate Lifford
Ellen Ligtenberg
Simon Mooijaart
Mark Pearson
Johanneke Portielje
Kathy Seddon
Stella Trompet
Frederikus A. Klok
Simon Noble
Isabelle Mahé
Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
Thrombosis Update
Antithrombotic treatment
Deprescription
Cancer
End of life
Palliative care
Delphi consensus
title Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
title_full Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
title_fullStr Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
title_full_unstemmed Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
title_short Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study
title_sort developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end of life care protocol for a european delphi study
topic Antithrombotic treatment
Deprescription
Cancer
End of life
Palliative care
Delphi consensus
url http://www.sciencedirect.com/science/article/pii/S2666572725000124
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