Study themes.

Cancer-associated thrombosis (CAT) can increase morbidity and mortality for cancer patients. Therefore, guidelines recommend predicting VTE risk and thromboprophylaxis for high-risk patients. Many studies critique oncologists’ adherence to thromboprophylaxis guidelines for cancer patients. Meanwhile, most of these studies did not discuss in detail the reasons and facilitators for oncologists’ adherence to thromboprophylaxis guidelines. Therefore, the current study aimed to explore in depth the perceptions and practices of oncologists working in oncology centers in Baghdad, Iraq, regarding VTE and its risk assessment among ambulatory cancer patients. A qualitative study with face-to-face individual-based interviews was conducted with oncologists working in four major oncology centers in Baghdad, Iraq using a semi-structured interview guide. The guide was developed based on previous relevant literature and validated by a panel of experts. The interviews were conducted from November 2023 to January 2024. Thematic analysis approach was used for data analysis. Thirty-one oncologists were interviewed in this study. Twenty-two of the interviewed oncologists reported that they detect VTE among their cancer patients. 64% of participating oncologists reported that they did not conduct VTE risk assessments for their cancer patients. Only four oncologists reported assessing VTE risk using the Khorana score. 58% of oncologists reported that they prescribe thromboprophylaxis for high-risk patients; meanwhile, only 11% of them reported prescribing anticoagulants in a dose similar to that reported by thromboprophylaxis guidelines. 77% of participating oncologists reported that pharmacists have a significant role in preventing cancer-related thrombosis by helping physicians prescribe a safe and effective prophylactic anticoagulant and in calculating VTE risk scores. In conclusion, CAT is commonly diagnosed among Iraqi cancer patients. VTE risk assessment for ambulatory cancer patients is rarely conducted by oncologists working at Oncology centers in Baghdad, Iraq. The prophylactic anticoagulants were rarely prescribed in appropriate dose and/or duration for patients at high risk of VTE. Pharmacists can help oncologists follow thromboprophylaxis guidelines by calculating VTE risk score and recommending a safe and effective dose of appropriate prophylactic anticoagulant.Educating and training oncologists about VTE risk assessment is recommended to enhance their practice in thromboprophlaxis.癌症相关血栓形成（Cancer-associated thrombosis, CAT）会升高癌症患者的发病率与死亡率，因此临床指南推荐对高风险患者开展静脉血栓栓塞症（Venous Thromboembolism, VTE）风险预测及血栓预防。诸多研究对肿瘤医师遵循癌症患者血栓预防指南的依从性提出了批评，但此类研究大多未深入探讨肿瘤医师依从血栓预防指南的动因与促进因素。本研究旨在深入探究伊拉克巴格达肿瘤中心的肿瘤医师针对门诊癌症患者的VTE及其风险评估的认知与实践情况。本研究采用质性研究设计，通过半结构化访谈指南，对伊拉克巴格达四家大型肿瘤中心的肿瘤医师开展面对面单人访谈；该访谈指南基于既往相关文献制定，并经专家小组验证。访谈实施时间为2023年11月至2024年1月，数据分析采用主题分析法。本研究共访谈31名肿瘤医师，其中22名受访肿瘤医师表示会在其接诊的癌症患者中筛查VTE；64%的受访肿瘤医师称未对癌症患者开展VTE风险评估；仅有4名肿瘤医师表示会采用科霍拉评分（Khorana score）进行VTE风险评估。58%的肿瘤医师表示会为高风险患者开具血栓预防处方，但仅11%的受访者表示其开具的抗凝药物剂量符合血栓预防指南的推荐标准。77%的受访肿瘤医师认为，药师可通过协助医师开具安全有效的预防性抗凝药物、计算VTE风险评分，在癌症相关血栓的预防中发挥重要作用。综上，伊拉克癌症患者中普遍存在CAT诊断情况，巴格达肿瘤中心的肿瘤医师极少对门诊癌症患者开展VTE风险评估，针对VTE高风险患者的预防性抗凝药物，其处方剂量及/或疗程极少符合规范。药师可通过计算VTE风险评分、推荐安全有效的适宜预防性抗凝药物剂量，协助肿瘤医师遵循血栓预防指南。研究建议对肿瘤医师开展VTE风险评估相关的教育培训，以提升其血栓预防临床实践水平。