Physicians are less likely to prescribe recommended oral anticoagulants to venous thromboembolism (VTE) patients facing housing insecurity or financial barriers.
RT’s Three Key Takeaways:
- Treatment Disparities: Research indicates that patients facing financial challenges or housing insecurity are less likely to receive prescriptions for direct oral anticoagulants to treat venous thromboembolism.
- Clinical Guidelines: While direct oral anticoagulants are the recommended standard of care for most blood clot patients, social determinants of health significantly influence whether physicians prescribe these medications.
- Patient Demographics: Previous data shows that pulmonary embolism disproportionately affects men, Black patients, and individuals living in rural areas, highlighting the need to address barriers to optimal care.
People who experience social and financial challenges are less likely to receive certain anticoagulant prescriptions for potentially deadly blood clots, according to a Michigan Medicine-led study.
In a national survey, physicians answered that they were less likely to prescribe direct oral anticoagulants (DOACs) to treat venous thromboembolism (VTE) if the patient had issues affording the drug or had no health insurance. Results of the study were presented as an abstract at the 2026 International Society on Thrombosis and Haemostasis Congress in Paris.
Clinical guidelines recommend prescribing DOACs for most patients with VTE, a condition in which clots form in the veins and block blood flow. VTE includes deep vein thrombosis, which involves clots in the legs, and pulmonary embolism (PE), which is the result of a clot blocking the artery in the lungs.
“Direct oral anticoagulants have transformed the treatment of venous thromboembolism, offering many patients a safer and more convenient alternative to vitamin K antagonists,” said Jordan K Schaefer, MD, MSc, clinical associate professor of internal medicine-hematology at University of Michigan Medical School, in a news release. “However, our findings suggest that social determinants of health continue to influence treatment decisions. The healthcare system must do more to address the social and financial factors that may limit patients’ access to the best treatment option for their circumstances.”
Physicians in the survey noted that patients with housing insecurity were less likely to receive a DOAC. Whether a participant spoke English natively also affected medical management, according to the study.
Past research from Michigan Medicine revealed that PE more often kills men, Black patients, and people from rural areas.
“We plan to further investigate the barriers that are precluding healthcare providers from offering their patients optimal anticoagulation care and what resources are needed to best overcome these barriers,” said Suman Sood, MD, MSCE, clinical associate professor of internal medicine-hematology at University of Michigan Medical School, in a news release.
The research team plans to use this information to propose strategies to help providers improve anticoagulation care while exploring the patient experience with navigating financial and social challenges to VTE care.
