Date of Graduation

8-15-2009

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mary Von, MS, PA-C

Second Advisor

Rob Rosenow PharmD, OD

Third Advisor

Annjanette Sommers MS, PA-C

Abstract

Background: A comparison of Low-Molecular Weight Heparin (LMWH) and oral anticoagulants is necessary in order to find the most effective prophylaxis for venous thromboembolism (VTE) and pulmonary embolism (PE) in cancer patients. The hypercoagulability state of cancer patients poses several risk factors and makes treatment and the potential complications more difficult to manage than in patients without cancer. By using the most effective treatment for anticoagulation in cancer patients, health care professionals can help reduce the risk of recurrent venous thromboembolism and/or pulmonary embolism while improving the quality of life.

Hypothesis: Low Molecular Weight Heparin will be the most effective and safest method of anticoagulation for prevention of recurrent venous thromboembolism and/or pulmonary embolism in cancer patients.

Study Design: Search of the most up to date medical literature to formulate a systematic review using 4 electronic databases and citations from other relevant articles.

Methods: The following databases were used to find the best research available: OVID-MEDLINE, CINAHL, and PubMed in addition to reference lists from the included articles.

Results: Four randomized, controlled clinical trials of various sample sizes which addressed this specific issue were reviewed; none of the studies were double-blinded and 2 out of 4 were terminated early due to poor recruitment of subjects.

Conclusion: LMWH is the preferred anticoagulation for cancer patients because Warfarin shows higher rates of recurrent VTE and higher risk for hemorrhage. More research is needed to solidify the evidence comparing anticoagulation in cancer patients.

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