How would you manage a provoked blood clot for a patient who had been placed on low dose DOAC for history of unprovoked blood clot?

To clarify the scenario: the patient had an unprovoked VTE for which they are currently on low dose DOAC and now have experienced recurrence in association with a well-defined (as outlined in ASH guidelines Ortel et al., PMID 33007077) provoking event. A number of additional variables would weigh in on the plan. 1) For treatment of the recurrent event, increasing the dose of DOAC to therapeutic doses is the standard approach. For long-term management, a number of variables come into play. e.g. If the provoked event occurred while continuously on the low dose DOAC or even if the DOAC was interrupted, then increasing the dose to standard therapeutic dose for at least 3 months (possibly longer depending on the seriousness of the event), and then consider decreasing the DOAC to prophylactic doses. In the end shared decision-making is important.