Hamostaseologie 2022; 42(03): 166-173
DOI: 10.1055/a-1554-4664
Original Article

Anticoagulation Therapy in Cancer Patients with Thrombosis in the Outpatient Sector of Germany (The CERTIFICAT Initiative)—German Practice of Anticoagulation Therapy of Cancer Patients with Thrombosis

Hanno Riess
1   Mediziniasche Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité, Universitätsmedizin Berlin, Berlin, Germany
Albrecht Kretzschmar
2   MVZ Mitte, Leipzig, Germany
Andreas Heinken
3   Aspen Germany GmbH, München, Germany
Damon Mohebbi
4   HGC Healthcare Consultants GmbH, Düsseldorf, Germany
Melanie May
4   HGC Healthcare Consultants GmbH, Düsseldorf, Germany
Sebastian Schellong
5   Department of Angiology, Städtisches Klinikum Dresden Friedrichstadt, Dresden, Germany
› Author Affiliations
Funding This study was supported by Aspen Germany GmbH.


Objective This article aims to investigate the reality of anticoagulation treatment for cancer patients with thrombosis in the outpatient sector of Germany.

Methods For the analysis period 2012 to 2015, anonymized data from 4.1 million statutory insured patients were analyzed. Cancer patients with incident thrombosis and an outpatient prescription of anticoagulant drugs were identified and evaluated for three subsequent quarters with regard to anticoagulant use.

Results A total of 7,313 cancer patients with incident thrombosis (ICD-10: I80*) were evaluated. About, 90% of patients with thromboses were diagnosed and treated in the ambulatory sector. More than 80% of the prescriptions were issued by general practitioners. And 57% of patients were anticoagulated predominantly (>50% of the time) with different low-molecular-weight heparins (LMWHs), 24% predominantly with vitamin K antagonists (VKAs), and 17% with direct oral anticoagulants (DOACs). Anticoagulants were prescribed for an average of 4.5 months. LMWH had a substantially longer prescription period (90–135 days) than VKA (53 days) or DOAC (47 days). Gastrointestinal bleeding in conjunction with hospitalization was documented in 1.76% of patients with a range of 1.3 to 3% for the different LMWHs.

Conclusion The prescription practice documented by this representative and comprehensive evaluation demonstrates an anticoagulation duration in accordance with the guidelines, although the choice of the respective anticoagulant was often not in compliance with the contemporary label or guidelines.

Publication History

Received: 15 February 2021

Accepted: 19 July 2021

Article published online:
08 December 2021

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