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Towards optimal use of antithrombotic therapy of people with cancer at the end of life: A research protocol for the development and implementation of the SERENITY shared decision support tool

Goedegebuur, J.; Abbel, D.; Accassat, S.; Achterberg, W. P.; Akbari, A.; Arfuch, V. M.; Baddeley, E.; Bax, J. J.; Becker, D.; Bergmeijer, B.; Bertoletti, L.; Blom, J. W.; Calvetti, A.; Cannegieter, S. C.; Castro, L.; Chavannes, N. H.; Coma-Auli, N.R.; Couffignal, C.P; Edwards, A.; Edwards, M.; Enggaard, H.; Font, C.; Gava, A.; Geersing, G. J.; Geijteman, E. C.T.; Greenley, S.; Gregory, C.; Gussekloo, J.; Hoffmann, I.; Højen, A. A.; van den Hout, W. B.; Huisman, M. V.; Jacobsen, S.; Jagosh, J.; Johnson, M. J.; Jørgensen, L.; Juffermans, C. C.M.; Kempers, E. K.; Konstantinides, S.; Kroder, A. F.; Kruip, M. J.H.A.; Lafaie, L.; Langendoen, J. W.; Larsen, T. B.; Lifford, K.; van der Linden, Y. M.; Mahé, I.; Maiorana, L.; Maraveyas, A.; Martens, E. S.L.; Mayeur, D.; van Mens, T. E.; Mohr, K.; Mooijaart, S. P.; Murtagh, F. E.M.; Nelson, A.; Nielsen, P. B.; Pearson, M.; Ording, A. G.; Ørskov, M.; Poenou, G.; Portielje, J. E.A.; Raczkiewicz, D.; Rasmussen, K.; Trinks-Roerdink, E.; Schippers, I....


J. Goedegebuur

D. Abbel

S. Accassat

W. P. Achterberg

A. Akbari

V. M. Arfuch

E. Baddeley

J. J. Bax

D. Becker

B. Bergmeijer

L. Bertoletti

J. W. Blom

A. Calvetti

S. C. Cannegieter

L. Castro

N. H. Chavannes

N.R. Coma-Auli

C.P Couffignal

A. Edwards

M. Edwards

H. Enggaard

C. Font

A. Gava

G. J. Geersing

E. C.T. Geijteman

C. Gregory

J. Gussekloo

I. Hoffmann

A. A. Højen

W. B. van den Hout

M. V. Huisman

S. Jacobsen

J. Jagosh

L. Jørgensen

C. C.M. Juffermans

E. K. Kempers

S. Konstantinides

A. F. Kroder

M. J.H.A. Kruip

L. Lafaie

J. W. Langendoen

T. B. Larsen

K. Lifford

Y. M. van der Linden

I. Mahé

L. Maiorana

E. S.L. Martens

D. Mayeur

T. E. van Mens

K. Mohr

S. P. Mooijaart

A. Nelson

P. B. Nielsen

A. G. Ording

M. Ørskov

G. Poenou

J. E.A. Portielje

D. Raczkiewicz

K. Rasmussen

E. Trinks-Roerdink

I. Schippers

K. Seddon

K. Sexton

S. Sivell

F. Skjøth

M. Søgaard

S. Szmit

S. Trompet

P. Vassal

C.M. Visser

L. M. van Vliet

E. Wilson

F. A. Klok

S. I.R. Noble


BACKGROUND: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. METHODS: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe. RESULTS: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. CONCLUSIONS: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers.


Goedegebuur, J., Abbel, D., Accassat, S., Achterberg, W. P., Akbari, A., Arfuch, V. M., …Noble, S. I. (2023). Towards optimal use of antithrombotic therapy of people with cancer at the end of life: A research protocol for the development and implementation of the SERENITY shared decision support tool. Thrombosis Research, 228, 54-60.

Journal Article Type Article
Acceptance Date May 5, 2023
Online Publication Date May 13, 2023
Publication Date Aug 1, 2023
Deposit Date Jul 3, 2023
Publicly Available Date Jul 6, 2023
Journal Thrombosis research
Print ISSN 0049-3848
Electronic ISSN 1879-2472
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 228
Pages 54-60
Keywords Neoplasms; Thrombosis; Hemorrhage; Palliative care; Anticoagulants; Deprescriptions
Public URL


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