Physicians' perceptions of risks and practices in venous thromboembolism prophylaxis in inflammatory bowel disease

Background: Hospitalized inflammatory bowel disease (IBD) patients are at a higher risk of venous thromboembolism (VTE). Aims: We aimed to determine perceptions of VTE risks and self-reported practices regarding VTE prophylaxis in hospitalized IBD patients among American gastroenterologists. Methods: Gastroenterologists who were members of the American Gastroenterological Association (AGA) and cared for IBD patients in the preceding 12 months were included. A survey assessed physicians' perceptions of VTE risks and their practices regarding VTE prophylaxis among IBD inpatients and other factors that may influence the decision to provide prophylaxis. Results: A total of 135 eligible gastroenterologists responded to the survey, 77 % of whom practiced in academic settings. Most physicians (84 %) reported having had IBD patients develop VTE. Only 67 % cared for IBD patients in hospitals that had protocols for VTE prophylaxis, and 45 % were aware of any published guidelines for VTE prophylaxis in hospitalized IBD patients. While only 7 % believed that any rectal bleeding was a contraindication to VTE chemoprophylaxis in hospitalized IBD patients with flares, 14 % never administered prophylaxis to IBD inpatients. A significant number of respondents felt that hospitalized IBD patients who were ambulatory (24 %) or in remission (28 %) did not require VTE prophylaxis. There was wide variation on recommendations for duration of anticoagulation for a first unprovoked VTE in an IBD patient. Conclusions: There is significant variation in reported practices for VTE prophylaxis in IBD patients among gastroenterologists. A more standardized approach to VTE prophylaxis should be implemented to improve health outcomes for IBD inpatients.