In 2014, World Thrombosis Day and Ipsos-Reid conducted a survey about public awareness of venous thromboembolism (VTE). Adults in nine countries, including: U.S., U.K., Canada, Germany, Argentina, The Netherlands, Thailand, Australia and Japan, were asked about their knowledge of the signs and symptoms, causes and prevention of VTE.
Survey results established a baseline of awareness for deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively known as VTE. Overall, results revealed some generally expressed awareness of dangerous blood clots but a significant lack of knowledge of the most important risk factors and little understanding that many VTE events can be prevented. This lack of knowledge may have important public health consequences.
AWARENESS OF PE AND DVT
- Among adults, an average of only about 50 percent were aware of, or had ever heard of the term pulmonary embolism and 44 percent were aware of, or had heard the term deep vein thrombosis. This is in stark contrast to 88 percent awareness of heart attack and 85 percent awareness of stroke among those polled. Furthermore, only 28 percent of those polled were concerned personally about pulmonary embolism and 27 percent were concerned about deep vein thrombosis.
- This lack of awareness and concern is important since the incidence of VTE is not much different from that of heart attack (at 1 to 2 cases per 1,000 people per year) and there are more deaths in Europe due to VTE than deaths from breast and prostate cancer, AIDS and road accidents combined.
- The highest awareness of deep vein thrombosis was in The United Kingdom, where 86 percent of individuals said they were aware of the condition. The lowest levels of awareness of DVT were in Japan (13 percent) and The Netherlands (20 percent). The country scoring the highest awareness of pulmonary embolism was Germany (82 percent) followed by The Netherlands (72 percent).
- With the exception of Japan and The Netherlands, older adults were more aware of deep vein thrombosis than their younger counterparts and women were more aware of DVT than men. In Japan, young men (age 18 to 39) were more likely to be aware of DVT than either men or women over age 65. Even so, DVT awareness in Japan is extremely low, with 20 percent awareness among young men and 10 percent awareness among older men and women.
AWARENESS OF RISK FACTORS
- Most respondents were not aware of a connection between hospital stays, surgery or cancer and VTE, even though these are the major risk factors for VTE. Only 25 percent believed hospitalization was a risk factor; only 16 percent of respondents believed cancer was a risk factor and only 36 percent considered surgery a risk factor. Studies have shown that in many countries the majority of VTE is related to hospitalization.
- On the other hand 52 percent of adults believed high cholesterol and 45 percent of adults believed high blood pressure causes VTE though neither of these conditions are linked to VTE.
- While 61 percent of respondents correctly reported that DVT is caused by a blood clot in the leg, 39 percent of those polled indicated that they were not aware of the causes of DVT or cited incorrect causes such as lack of oxygen in a vein.
AWARENESS OF WHAT A CLOT WOULD FEEL LIKE
- Only 28 percent of respondents said they would know what a blood clot in the leg would feel like. 35 percent of those who claimed to know what a blood clot in the leg would feel like, however, misidentified the signs of a blood clot. Only 19 percent asserted that they know what a blood clot in the lungs—a pulmonary embolism—would feel like.
- The lack of awareness of the signs of VTE and PE indicate that there is much to be done in public education. In other disease areas, such as heart attack and stroke, mortality rates in Western nations are going down as public awareness of the warning signs of these conditions increase.
AWARENESS OF PREVENTION
- Many adults were not aware that in some cases, blood clots can be prevented. 55 percent of individuals either were not aware that they can often be prevented or expressed no opinion about this question. 44 percent of respondents did not believe that blood clots in the leg could travel to the lungs, or expressed no view on this question.
- Deep vein thrombosis and pulmonary embolism can often be prevented by people being aware of risk factors (such as not moving for long periods of time, surgery and hospitalization), engaging their healthcare professionals in a dialogue about evidence-based prevention, and seeking medical aid if they experience the signs of these conditions, such as swelling of the leg in the case of DVT and shortness of breath or chest pain in the case of pulmonary embolism. In hospitalized patients appropriate risk evaluation and evidence based prevention measures are particularly critical.
Unlike heart attack and stroke, VTE is not a result of poor diet, lack of exercise or other lifestyle choices; in fact, thrombotic events can occur in seemingly healthy individuals. In hospitals, VTE causes more disability than hospital-acquired pneumonia and sepsis and is the most common cause of preventable hospital deaths. Winning enhanced public recognition of the signs and symptoms of the disorder and its causes is clearly an important public health need everywhere. This survey indicates that there is much work to be done to achieve this.
Ipsos Healthcare conducted the survey in July through August 2014 via the Internet in the native languages of the participants. Approximately 800 adults were polled in nine countries: Argentina, Australia, Canada, Germany, Japan, The Netherlands, Thailand, The United Kingdom and The United States. In all countries but Japan and Thailand the samples included 160 persons age 18 to 39, 320 people age 40 to 64 and 320 people older than 64. Because of logistical considerations, in Japan and Thailand 160 people age 18 to 39 and 640 people over age 40 were surveyed. Results were weighted to reflect the percentage of individuals in these age bands based on most current local census data.
This is a professional survey. Statistical testing was performed at the 95% confidence interval, and statistical differences between countries are listed on many bar graphs.
This survey was conducted online. Increasingly public surveys are being conducted online rather than via telephone. While a few years ago people might have questioned this methodology, today the prevalence of Internet access makes it a reliable –and more cost effective–way to poll individuals.
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