{
  "abstract": "Background Venous thromboembolism (VTE) contributes to hospitalisation-associated morbidity. Although guidelines recommend limiting VTE prophylaxis to high-risk patients, some physicians prescribe it broadly. We compared beliefs of low and high prescribing physicians.Methods We surveyed hospitalists and medical residents who had the opportunity to prescribe prophylaxis ≥50 times. Best-worst scaling was used to assess their beliefs. Using a balanced incomplete block design, we created seven choice tasks with seven statements regarding prophylaxis beliefs each presented four times. For each task, physicians selected the statement that most and least reflected their beliefs. We used a count method to calculate best-worst scores and a conditional logistic regression choice model to compare low and high prescribers.Results Of 434 invitees, 172 (40%) completed all survey questions between June and November 2023. Low (n=86, ≤62.5% prescribing rate) and high (n=86, >62.5 prescribing rate) prescribers endorsed similar beliefs with differing levels of agreement. All felt confident to prescribe prophylaxis appropriately (low: +1.13, high: +1.10, p=0.81). High prescribers expressed more concern about VTE without prophylaxis (+1.02 vs +0.65, p=0.002). Low prescribers disagreed more that prophylaxis had no downside (−1.03 vs −0.73, p=0.01). High prescribers worried less about prophylaxis risks (−0.49 vs −0.22, p=0.01), and overuse (−0.61 vs −0.34, p=0.02).Conclusions Compared with low prescribers, high prescribers were more concerned about VTE without prophylaxis and less about harms. These differences in beliefs may underlie physician behaviour and could be targets for interventions to reduce inappropriate prophylaxis.",
  "authors": [
    {
      "affiliations": [
        "Department of Hospital Medicine, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Stephanie R Moss"
    },
    {
      "affiliations": [
        "Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"
      ],
      "name": "Oindrila Bhattacharyya"
    },
    {
      "affiliations": [
        "Center for Value-Based Care Research, Department of Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, Ohio, USA",
        "Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"
      ],
      "name": "Benjamin G Mittman"
    },
    {
      "affiliations": [
        "Department of Hospital Medicine, Ochsner Baptist Medical Center, New Orleans, Louisiana, USA"
      ],
      "name": "Tarini Gunaratne"
    },
    {
      "affiliations": [
        "Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"
      ],
      "name": "Nicola B Campoamor"
    },
    {
      "affiliations": [
        "Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"
      ],
      "name": "John FP Bridges"
    },
    {
      "affiliations": [
        "Center for Value-Based Care Research, Department of Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Michael B Rothberg"
    }
  ],
  "title": "Physician beliefs regarding venous thromboembolism prophylaxis at a large multihospital US healthcare system: a cross-sectional survey study",
  "uid": "265fb68f-a670-5b50-a926-38d9d9edaa23"
}