Factor V Leiden Screening in Reproductive Age Women: A Need for Shared Decision Making
Speaker Credentials
MS-II
College
College of Allopathic Medicine
Format
Poster
Start Date
6-11-2020 1:45 PM
End Date
6-11-2020 2:00 PM
Abstract
Background: Factor V Leiden (FVL) is the most prevalent thrombophilia and confers increased thrombotic risk, especially in women using oral contraceptives. Tier 1 status is given to a genetic disorder by the CDC when there is utility and testing will have a positive impact on public health. Currently, this does not exist for FVL. Objective: Our objective was to inform women of FVL and its contribution to VTE, particularly in the setting of OCPs, and then assess their perspective regarding screening. We sought to suggest warranted and actionable change for screening of FVL in reproductive age women prior to the prescription of OCPs through shared-decision making and individualized, patient-centered care. Methods: A voluntary, anonymous survey was conducted to ascertain women’s willingness to alter birth control methods and/or to undergo screening for both their daughters and themselves, as well as their belief in, and willingness to pay for, universal screening for all women. Education about concurrent risk factors was provided prior to surveying. Results: 69.1% of women surveyed were in favor of screening for FVL before prescription of OCPs for themselves, and 80.6% of these women were in favor of screening for their daughters before OCP prescription. Additionally, 81.4% of these women would seek alternative birth control with knowledge of a positive mutation, and 80.6% of women were in favor of screening before pregnancy. Notably, 65.8% of these women would be in favor of paying $150 for the screening. Conclusion: We assert that clinicians have an obligation to inform their female patients of the VTE risk from FVL before prescription of OCPs. This shared decision-making supports our contention that FVL should be considered for Tier One Status by the CDC, although future studies should be conducted.
Factor V Leiden Screening in Reproductive Age Women: A Need for Shared Decision Making
Background: Factor V Leiden (FVL) is the most prevalent thrombophilia and confers increased thrombotic risk, especially in women using oral contraceptives. Tier 1 status is given to a genetic disorder by the CDC when there is utility and testing will have a positive impact on public health. Currently, this does not exist for FVL. Objective: Our objective was to inform women of FVL and its contribution to VTE, particularly in the setting of OCPs, and then assess their perspective regarding screening. We sought to suggest warranted and actionable change for screening of FVL in reproductive age women prior to the prescription of OCPs through shared-decision making and individualized, patient-centered care. Methods: A voluntary, anonymous survey was conducted to ascertain women’s willingness to alter birth control methods and/or to undergo screening for both their daughters and themselves, as well as their belief in, and willingness to pay for, universal screening for all women. Education about concurrent risk factors was provided prior to surveying. Results: 69.1% of women surveyed were in favor of screening for FVL before prescription of OCPs for themselves, and 80.6% of these women were in favor of screening for their daughters before OCP prescription. Additionally, 81.4% of these women would seek alternative birth control with knowledge of a positive mutation, and 80.6% of women were in favor of screening before pregnancy. Notably, 65.8% of these women would be in favor of paying $150 for the screening. Conclusion: We assert that clinicians have an obligation to inform their female patients of the VTE risk from FVL before prescription of OCPs. This shared decision-making supports our contention that FVL should be considered for Tier One Status by the CDC, although future studies should be conducted.