Barriers and facilitators to deprescribing antithrombotic therapy in advanced cancer patients: A qualitative interview study of patients’, companions’ and clinicians’ experiences and perspectives
Many people with advanced cancer take blood-thinning medicines to prevent blood clots or manage heart conditions. While these medicines are important, they can also cause side effects like bruising or bleeding. As cancer advances, doctors may suggest stopping blood thinners to protect a person's comfort and quality of life. However, very little is known about how patients and their families feel about this choice. This study invites patients and their carers to share their thoughts in a single 30 to 60-minute interview. You will not be asked to change or stop your medicines. The researchers will use your experiences to create a practical app. This app will help future patients, families, and doctors work together to make shared choices about blood thinners near the end of life.
At a glance
What is this study about?
Blood-thinning medicines are often prescribed to prevent strokes, manage heart conditions, or treat blood clots in the legs and lungs. For people living with advanced cancer, these medicines can bring both benefits and risks. As cancer progresses, blood thinners can increase the chance of bleeding, which may cause pain, distress, or extra hospital visits. In some cases, stopping the medicine might be the safest option, but this can be a difficult and worrying decision for patients and their families.
At present, healthcare teams do not fully understand what matters most to patients and their loved ones when thinking about stopping these medicines. Doctors want to know what concerns you have, what information you need, and how you prefer to make these choices. This European research study gives patients and their carers an opportunity to talk openly about their experiences and wishes.
The feedback gathered from these interviews will be used to design a new digital tool, such as a mobile app. In the future, this app will guide patients and healthcare professionals through open conversations, ensuring that care decisions reflect what is truly important to each individual.
Key takeaways
- A qualitative research study exploring thoughts on stopping blood thinners in advanced cancer.
- Involves a single 30 to 60-minute conversation with a researcher.
- Carers and loved ones are welcome to join the interview.
- You do not need to change or stop any of your current medicines.
- Findings will help create an app to assist future patients and doctors in making care decisions together.
Who may be eligible?
You may be able to join this study if you are 18 or older, have advanced cancer, and are currently taking a blood-thinning medicine. This includes blood thinners taken for irregular heart rhythms, heart valve replacements, poor circulation, or previous blood clots. You must be well enough to take part in a short conversation and able to complete the interview in English.
If you take part, you are welcome to invite a family member, friend, or carer to join the interview with you, provided they are also an adult and can speak English.
You cannot take part if you are feeling too unwell to manage a 30 to 60-minute conversation, or if you have memory or thinking problems that make it hard to give informed consent.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- I am aged 18 or over.
- I have been diagnosed with advanced cancer.
- I am currently taking a blood-thinning medicine (such as for a blood clot or heart condition).
- I feel well enough to manage a 30 to 60-minute conversation.
- I can comfortably understand and speak English.
What does participation involve?
Taking part in this study involves a single interview lasting between 30 and 60 minutes. You can choose to have this conversation on your own or alongside a family member, friend, or carer. During the chat, a trained researcher will ask gentle questions about your experiences with blood thinners, your thoughts on continuing or stopping them, and what kind of support you need from your healthcare team.
There are no extra clinic visits, blood tests, or physical examinations. You will not be asked to change, reduce, or stop any of your usual medicines. Once the single interview is finished, your participation in the study is complete, and there are no long-term follow-up visits required.
Potential risks and benefits
Locations (7)
- Aneurin Bevan UHBCity onlyNewport, Wales
- Cardiff and Vale UHBCity onlyCardiff, Wales
- Velindre Cancer CentreApproximateCardiff, Wales
- Aalborg University HospitalCity onlyAalborg, Denmark
- Aalborg University HospitalCity onlyAalborg, Denmark
- Hospital Clinic de BarcelonaUnverifiedBarcelona, Spain
- Hopitaux de ParisUnverifiedParis, France
Common questions
Will taking part change the medicines I take?
No. This study is only an interview. The researchers will not change, reduce, or stop your blood thinners or any other treatments.
Can my partner or carer join the interview?
Yes. You are welcome to invite a family member, partner, or unpaid carer to take part alongside you if you wish.
What happens if I feel too tired or unwell during the interview?
You can take a break, rearrange the interview for another day, or stop the chat at any point. Your comfort and wellbeing always come first.
Where does the interview take place?
Interviews are arranged to be as convenient as possible. The research team will explain whether your interview can take place in person, over the telephone, or via a secure video call.
Will taking part affect my relationship with my cancer team?
Not at all. Your decision to take part, or to withdraw, is completely voluntary and will not affect your standard care or treatment in any way.
How to find out more
Annmarie Nelson
Always speak to your GP or specialist before deciding to take part in a study.
Discussion
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