"Who am I to say that I'm not going to take it": patient perspectives on decisions about antithrombotic therapy in the context of advanced cancer.

INTRODUCTION

The decision to reconsider antithrombotic therapy (ATT) in cancer patients nearing the end of life is complex given the increasing risk of haemorrhage and thrombosis. A decision support tool (DST) is being developed to facilitate this process. Understanding patients' experiences, values, and perspectives are an essential component, yet remain largely unexplored.

AIM: To explore these patients' experiences, values and perspectives regarding ATT use.

METHODS

Qualitative study using semi-structured interviews with patients with advanced cancer receiving ATT, across Denmark, France, Spain, and the United Kingdom. Data were analysed using Framework Analysis.

RESULTS

Sixty patients and 13 relatives participated. Three major themes were generated:

CONCLUSION

Patients found decision-making around ATT near the end of life multifaceted, occurring amid a myriad of competing priorities. While patients reported a reticence to discontinuing, ultimately many deferred such decisions to a clinician, whose role was highly valued. These findings support a need for a DST, to support informed and shared choices in ATT decisions.