{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:40:40Z","timestamp":1787614840782,"version":"build-2736575974"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Venous thromboembolism (VTE) is a common, potentially life-threatening condition. To improve care, a multidisciplinary Adult Outpatient Thrombosis Service (TS) was implemented in one region of Newfoundland and Labrador, Canada. This study evaluated the clinical effectiveness of the TS compared to usual care (UC) for patients with newly diagnosed VTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults with objectively confirmed VTE between 2017 and 2019. Patients managed by the TS were compared to those receiving UC. Data were obtained from linked administrative and clinical databases. Propensity score matching was applied to control for confounding. Primary outcomes included recurrent VTE and major bleeding. Secondary outcomes were all-cause hospitalizations, emergency department visits, and all-cause mortality. Incidence rate ratios (IRR) and 95% CIs were calculated using Poisson regressions; Cox models were used for mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 1499 patients were included (TS:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 464; UC:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1035). The TS group experienced significantly lower rates of adverse outcomes. VTE recurrence (IRR = 0.65, 95% CI: 0.29\u20130.67,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = &lt; 0.001) and major bleeding (IRR = 0.33, 95% CI: 0.19\u20130.53,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.011) were significantly reduced in the TS group, as were hospitalizations (IRR = 0.76, 95% CI: 0.64\u20130.92,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.009). No significant difference was found in emergency department visits (IRR = 1.02, 95% CI: 0.79\u20131.32,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.848). All-cause mortality was also lower (HR = 0.62, 95% CI: 0.48\u20130.81,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Management of VTE within a multidisciplinary TS was associated with significantly lower rates of complications, hospitalizations, and all-cause mortality compared to UC. These findings suggest that a structured, specialized outpatient thrombosis care model may be associated with favorable clinical outcomes in real-world settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x261430616","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:17:51Z","timestamp":1781093871000},"page":"329-337","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical effectiveness of a multidisciplinary thrombosis service versus usual care in the management of venous thromboembolism: A retrospective cohort study"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-5395","authenticated-orcid":false,"given":"Kwadwo O","family":"Bonsu","sequence":"first","affiliation":[{"name":"School of Pharmacy, Memorial University of Newfoundland, St John\u2019s, NL, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rufaro S","family":"Chitsike","sequence":"additional","affiliation":[{"name":"Division of Hematology, Newfoundland and Labrador Health Services, St John\u2019s, NL, Canada"},{"name":"Faculty of Medicine (Hematology), Memorial University of Newfoundland and Labrador, St John\u2019s, NL, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5207-2186","authenticated-orcid":false,"given":"Tiffany A","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Memorial University of Newfoundland, St John\u2019s, NL, Canada"},{"name":"Pharmacy Program, Newfoundland and Labrador Health Services, St John\u2019s, NL, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai V","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Memorial University of Newfoundland, St John\u2019s, NL, Canada"},{"name":"Department of Economics and Finance, Lang School of Business, University of Guelph, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-4706","authenticated-orcid":false,"given":"Cindy","family":"Whitten","sequence":"additional","affiliation":[{"name":"Department of Research and Innovation, Newfoundland and Labrador Health Services, St John\u2019s, NL, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie W","family":"Young","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Memorial University of Newfoundland, St John\u2019s, NL, Canada"},{"name":"Pharmacy Program, Newfoundland and Labrador Health Services, St John\u2019s, NL, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2020.10.030"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001830"},{"key":"e_1_3_2_4_2","unstructured":"Newfoundland and Labrador Centre for Applied Health Research. One Umbrella: Evaluating Healthcare Efficiency at Eastern Health\u2019s Adult Outpatient Thrombosis Service. In : Venous thromboembolism: a public health issue in Newfoundland and Labrador. Memorial University of Newfoundland St John\u2019s NL https:\/\/www.mun.ca\/nlcahr\/media\/production\/memorial\/administrative\/nl-centre-for-applied-health-research\/media-library\/researchexchange\/Thrombosis_May_2019.pdf (2019 accessed Oct 14 2025)."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S85635"},{"key":"e_1_3_2_6_2","unstructured":"American College of Cardiology. CHEST Guideline for Antithrombotic Therapy in VTE https:\/\/www.acc.org\/latest-in-cardiology\/ten-points-to-remember\/2016\/03\/02\/15\/45\/antithrombotic-therapy-for-vte-disease (2016 accessed Sep 10 2018)."},{"key":"e_1_3_2_7_2","first-page":"405","article-title":"Outpatient management of deep venous thrombosis: 2 models of integrated care","volume":"12","author":"Vinson DR","year":"2006","unstructured":"Vinson DR, Berman DR, Patel PB, Hickey DO. Outpatient management of deep venous thrombosis: 2 models of integrated care. Am J Manag Care 2006; 12: 405\u2013410.","journal-title":"Am J Manag Care"},{"key":"e_1_3_2_8_2","article-title":"Home versus in-patient treatment for deep vein thrombosis","volume":"1","author":"Othieno R","year":"2018","unstructured":"Othieno R, Okpo E, Forster R. Home versus in-patient treatment for deep vein thrombosis. Cochrane Database Syst Rev 2018; 1: CD003076.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029618811082"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2017.08.001"},{"key":"e_1_3_2_11_2","first-page":"184","article-title":"[Evaluation of an \u201cEmergency Thrombosis\u201d care system in a university-hospital department of general emergencies]","volume":"44","author":"El Yaagoubi A","year":"2019","unstructured":"El Yaagoubi A, Michelet P, Va\u00efsse B, et al. [Evaluation of an \u201cEmergency Thrombosis\u201d care system in a university-hospital department of general emergencies]. J Med Vasc 2019; 44: 184\u2013193.","journal-title":"J Med Vasc"},{"key":"e_1_3_2_12_2","volume-title":"Atrius Health Anticoagulation Management Service Clinical Guideline and Practice Protocol","author":"Brush A","year":"2021","unstructured":"Brush A, Collins P, Deicicchi D, et al. Atrius Health Anticoagulation Management Service Clinical Guideline and Practice Protocol. Atrius Health. https:\/\/acforum-excellence.org\/Resource-Center\/resource_files\/-2021-08-05-172342.pdf. (May 20, 2021. Accessed August, 11, 2025)."},{"key":"e_1_3_2_13_2","unstructured":"Collaborative Practice Agreement: Outpatient Thrombosis Service. Anticoagulation Forum Resource Center. https:\/\/acforum-excellence.org\/Resource-Center\/resource_files\/-2023-11-29-130945.pdf? (Sept 2 2021. 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