Version June 2024
| Overall treatment plan and prognosis |
| Therapeutic goal (eg, palliation of symptoms related to VTE, planned oncologic intervention, immediate prognosis, hospice care) |
| Planned chemotherapy |
| Stage of the malignancy, overall prognosis |
| Other causes for hypercoagulability (eg, bedridden, pathologic fracture, recent surgery or invasive procedures, use of hormonal agents or other medications with a high incidence of thrombotic side effects, presence of a central venous access line) |
| Patient preferences, logistic, and financial issues |
| Inpatient or outpatient care planned |
| Who will supervise medication's use and required monitoring, if any? |
| Patient preferences (eg, oral versus injectable agent, need for frequent monitoring of coagulation status) |
| Treatment costs; Will the patient's insurance pay for the medication? |
| Relative contraindications to anticoagulation |
| Presence of central nervous system involvement |
| - Central nervous system primary or metastases |
| - Prior intracerebral hemorrhage |
| Thrombocytopenia or bleeding diathesis present? |
| Are risk factors for bleeding after use of warfarin present? (eg, impaired liver function, hepatic metastases, concomitant medication, poor nutrition) |
| Selection of appropriate dosing (eg, impaired renal function, obesity, advanced age) |
| Need for monitoring of treatment (eg, INR for treatment with warfarin) |
| Ability or inability to reverse anticoagulation if bleeding occurs |
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