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Decision Aid for Anticoagulation Duration After Unprovoked Venous Thromboembolism (DECIDE-VTE)

2026年6月19日 更新者：Marc Rodger、McGill University Health Centre/Research Institute of the McGill University Health Centre

Enabling and Engaging Patients to Decide Indefinite Versus Short-Term Anticoagulation for Venous Thromboembolism (DECIDE-VTE)

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common condition that is typically treated with blood thinners (anticoagulants). After completing at least 3 months of treatment for a first unprovoked or weakly provoked VTE, patients and clinicians must decide whether to stop anticoagulation or continue treatment for a longer period. Continuing anticoagulation reduces the risk of another blood clot but increases the risk of bleeding. Because both options involve important benefits and risks, this decision should reflect the patient's values and preferences.

The DECIDE-VTE study will evaluate whether a patient decision aid can improve decision-making for patients facing this choice. The decision aid provides evidence-based information about the risks and benefits of continuing versus stopping anticoagulation and includes a values clarification exercise to help patients identify what matters most to them.

This multicentre batched stepped-wedge cluster randomized trial will be conducted in 12 thrombosis clinics across Canada. Clinics will transition from usual care to implementation of the patient decision aid according to a randomized schedule. The primary outcome is decisional conflict immediately following the anticoagulation decision visit, measured using the Decisional Conflict Scale. Secondary outcomes include patient knowledge, treatment decisions, decisional regret, concordance with the chosen treatment strategy, recurrent venous thromboembolism, major bleeding, all-cause mortality, and implementation outcomes.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is commonly treated with anticoagulation. After completing initial anticoagulation for a first unprovoked or weakly provoked VTE, patients and clinicians must decide whether to discontinue anticoagulation or continue treatment long term. This is a preference-sensitive decision because continued anticoagulation reduces the risk of recurrent VTE but increases the risk of bleeding.

The DECIDE-VTE Patient Decision Aid was developed to support shared decision-making about anticoagulation duration. The tool provides structured information about treatment options, recurrence and bleeding risks, and includes a values-clarification exercise to help patients consider which outcomes and treatment burdens matter most to them.

This study is a pragmatic, multicentre, batched stepped-wedge cluster randomized trial. Participating thrombosis clinics begin in the usual care phase and transition to implementation of the DECIDE-VTE Patient Decision Aid according to a randomized schedule. Randomization occurs at the clinic level to reduce contamination between study conditions and to reflect real-world implementation of the decision aid into routine thrombosis clinic care.

The study will assess whether integrating the DECIDE-VTE Patient Decision Aid into clinical care improves decision quality compared with usual care, and will also evaluate implementation-related measures relevant to future use of the tool in practice.

研究の種類

介入

入学 (推定)

850

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

  • カナダ
    • Alberta
      • Calgary、Alberta、カナダ、T2N 1N4
        • University Of Calgary
        • コンタクト：
        • 主任研究者：
          • Leslie Skieth, MD FRCPC
    • British Columbia
      • Vancouver、British Columbia、カナダ、V5Z 1N1
        • Vancouver General Hospital
        • コンタクト：
        • 主任研究者：
          • Rick Ikesaka, MD MSc. FRCPC DRCPSC
    • Ontario
      • Ottawa、Ontario、カナダ、K1H 8L6
        • Ottawa Hospital - General Campus
        • コンタクト：
        • 主任研究者：
          • Deborah Siegal, MD MSc FRCPC
    • Quebec
      • Montreal、Quebec、カナダ、H3T 1E2
        • Sir Mortimer B. Davis Jewish General Hospital
        • コンタクト：
      • Montreal、Quebec、カナダ、H4A 3J1
        • Research Institute of McGill University Health Centre
        • コンタクト：

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria:

  • Age 18 years or older
  • First episode of objectively confirmed unprovoked or weakly provoked venous thromboembolism (VTE)
  • Objectively confirmed proximal deep vein thrombosis and/or segmental or greater pulmonary embolism
  • Completed at least 3 months of therapeutic anticoagulation and currently receiving anticoagulation
  • Enrollment within 12 months of diagnosis of the index/qualifying VTE event
  • Able to provide written informed consent
  • Able to participate in shared decision-making in English or French

Exclusion Criteria:

  • Recurrent unprovoked or weakly provoked VTE I(i.e. multiple unprovoked/weakly provoked VTE)
  • Index/qualifying VTE is a strongly provoked VTE (e.g., associated with major surgery, major trauma, plaster cast immobilization, or prolonged bed rest)
  • Index/qualifying VTE associated with a persistent strong provoking risk factor (e.g., active cancer or ongoing immobility)
  • Women at very low recurrence risk (HERDOO2 score 0-1)
  • High bleeding risk such that anticoagulation should be discontinued
  • Requirement for long-term anticoagulation for another indication (e.g., atrial fibrillation)
  • Prior dedicated long-term anticoagulation Decision Visit regarding anticoagulation duration

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：支持療法
  • 割り当て：ランダム化
  • 介入モデル：クロスオーバー割り当て
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
介入なし：Usual Care
Participants receive standard thrombosis clinic care and clinician-patient discussions regarding continuation versus discontinuation of anticoagulation following a first unprovoked or weakly provoked venous thromboembolism. No structured patient decision aid is used.
実験的：DECIDE-VTE Patient Decision Aid
Participants receive the DECIDE-VTE Patient Decision Aid in addition to usual thrombosis clinic care. The decision aid provides evidence-based information regarding the risks and benefits of continuing versus discontinuing anticoagulation after a first unprovoked or weakly provoked venous thromboembolism and includes a structured values clarification exercise to support shared decision-making. Participants and clinicians make the final treatment decision together during the Decision Visit.
行動：DECIDE-VTE Patient Decision Aid
The DECIDE-VTE Patient Decision Aid is a bilingual (English/French) evidence-based decision support tool designed for adults with a first unprovoked or weakly provoked venous thromboembolism who are deciding whether to continue or discontinue anticoagulation after completing at least 3 months of therapy. The decision aid presents balanced information regarding the risks and benefits of extended anticoagulation, including risks of recurrent venous thromboembolism and major bleeding, and incorporates a structured values clarification exercise to support shared decision-making between patients and clinicians during the anticoagulation Decision Visit.

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Decisional Conflict Scale (DCS) Total Score
時間枠：Decision Visit (Day 0)
Decisional conflict measured using the validated 16-item Decisional Conflict Scale (DCS). Total scores range from 0 to 100, with higher scores indicating greater decisional conflict.
Decision Visit (Day 0)

二次結果の測定

結果測定
メジャーの説明
時間枠
VTE Knowledge Assessment Score
時間枠：Decision Visit (Day 0)
Patient knowledge regarding recurrent venous thromboembolism and bleeding risks assessed using a 6-item true/false questionnaire. Scores range from 0 to 6, with higher scores indicating greater knowledge.
Decision Visit (Day 0)
Treatment Decision
時間枠：Decision Visit (Day 0)
Patient decision regarding continuation versus discontinuation of anticoagulation therapy.
Decision Visit (Day 0)
Decisional Regret Scale (DRS) Score
時間枠：3-Month Follow-Up Visit (Day 90 ± 14 days)
Decisional regret measured using the validated 5-item Decisional Regret Scale (DRS). Scores range from 0 to 100, with higher scores indicating greater regret regarding the treatment decision.
3-Month Follow-Up Visit (Day 90 ± 14 days)
Concordance With Treatment Decision
時間枠：3-Month Follow-Up Visit (Day 90 ± 14 days) and 12-Month Follow-Up Visit (Day 365 ± 60 days)
Agreement between the treatment decision made at the Decision Visit (Day 0) and participant-reported anticoagulant use status at follow-up.
3-Month Follow-Up Visit (Day 90 ± 14 days) and 12-Month Follow-Up Visit (Day 365 ± 60 days)
Recurrent Venous Thromboembolism
時間枠：12-Month Follow-Up Visit (Day 365 ± 60 days)
Adjudicated objectively confirmed recurrent venous thromboembolism assessed using the INVENT VERDICT adjudication process.
12-Month Follow-Up Visit (Day 365 ± 60 days)
Major Bleeding
時間枠：12-Month Follow-Up Visit (Day 365 ± 60 days)
Adjudicated objectively confirmed major bleeding defined according to International Society on Thrombosis and Haemostasis criteria.
12-Month Follow-Up Visit (Day 365 ± 60 days)
All-Cause Mortality
時間枠：12-Month Follow-Up Visit (Day 365 ± 60 days)
Death from any cause identified through medical record review and, where necessary, provincial vital statistics records.
12-Month Follow-Up Visit (Day 365 ± 60 days)

その他の成果指標

結果測定
メジャーの説明
時間枠
Patient Decision Aid Use Time
時間枠：Decision Visit (Day 0)
Time in minutes spent interacting with the DECIDE-VTE Patient Decision Aid.
Decision Visit (Day 0)
Physician Visit Duration
時間枠：Decision Visit (Day 0)
Time in minutes from the participant entering the clinic room with the physician until completion of the clinical encounter.
Decision Visit (Day 0)

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

McGill University Health Centre/Research Institute of the McGill University Health Centre

捜査官

  • 主任研究者：Marc Rodger, MD MSc FRCPC、McGill University

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年9月1日

一次修了 (推定)

2028年3月1日

研究の完了 (推定)

2029年3月1日

試験登録日

最初に提出

2026年6月5日

QC基準を満たした最初の提出物

2026年6月16日

最初の投稿 (実際)

2026年6月22日

学習記録の更新

投稿された最後の更新 (実際)

2026年6月24日

QC基準を満たした最後の更新が送信されました

2026年6月19日

最終確認日

2026年6月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • DECIDE-VTE-SWRCT
  • 202509PJT-552796-CID-CFAC-5562 (その他の識別子：Canadian Institute of Health Research)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD 共有時間枠

TBD near end of follow-up of last participant

IPD 共有アクセス基準

contact study PI

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL
  • SAP

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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