Do you routinely use risk assessment scores (e.g., the Khorana score) to assess the risk of venous thromboembolism and consideration of prophylactic anticoagulation in ambulatory cancer patients undergoing / about to undergo treatment?

Guidelines recommend considering prophylactic anticoagulation for ambulatory patients with cancer without established venous thromboembolism. What are major barriers for prophylactic anticoagulation consideration and prescription? (please select top 3)

• Lack of improvement in overall survival
• Efficacy data for VTE prevention are not compelling enough
• Lack of efficacy data beyond 6 months
• Concern regarding bleeding risk (outweighing benefit in VTE prevention)
• Concern regarding drug costs/ insurance approval (not yet FDA approved)
• Concern regarding polypharmacy/ adding another medication
• Concern regarding drug interactions with systemic chemotherapy
• Concern regarding dosing with organ (liver, kidney) dysfunction
• Clinical inertia and lower priority in a patient initiating therapy
• Other