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The Surgeon General's Call to Action Exemplifies the Role of Advocacy in Preventing Venous Thromboembolism

      Deep vein thrombosis and pulmonary embolism are not as well publicized as disease states such as heart attack and stroke. Only recently has venous thromboembolism been discussed widely within the medical community. Clinicians and survivors of deep vein thrombosis and pulmonary embolism have brought this illness to national attention. The collaboration of nonprofit organizations such as the North American Thrombosis Forum and the Venous Disease Coalition, celebrity figures, patients, nurses, pharmacists, and physicians has heightened awareness. The Surgeon General's decision to select deep vein thrombosis and pulmonary embolism as a targeted disease area is a credit to patients and clinicians who have advocated for intensified prevention efforts. Advocacy has resulted in government-sponsored publications providing a range of educational booklets, slides, and articles related to venous thromboembolism. These publications are targeted to health care providers, the public, and administrators.
      In response to venous thromboembolism coalitions that requested Federal leadership, the Surgeon General and the National Heart, Lung, and Blood Institute convened a 2-day Surgeon General's Workshop on deep vein thrombosis in May 2006.
      Surgeon General's Workshop on Deep Vein Thrombosis.
      The Workshop was cosponsored by Surgeon General Richard Carmona, MD, MPH, and Elizabeth Nabel, MD, Director of the National Heart, Lung, and Blood Institute. Carmona's term as Surgeon General expired in August 2006. On October 1, 2007, Steven K. Galson, MD, MPH, was appointed Acting Surgeon General. Galson released “The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism” on September 15, 2008, at the Venous Disease Coalition's Second Annual Meeting in Washington, DC. The 49-page pdf can be downloaded at the Surgeon General's website.
      The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism.
      The Surgeon General's Office also prepared a Fact Sheet on deep vein thrombosis and pulmonary embolism that targets the public and that focuses on risk factors, diagnosis, and tips for travelers. At the same time the Surgeon General's Call To Action was released, the Agency for Healthcare Research and Quality, directed by Carolyn M. Clancy, MD, coordinated its publication of 2 related items: one for health care professionals (“Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement”) and one for the public (“Your Guide to Preventing and Treating Blood Clots”).
      Your Guide to Preventing and Treating Blood Clots.
      In the foreword, Steven K. Galson, MD, MPH, Acting Surgeon General, estimates that between 350,000 and 600,000 Americans each year have acute deep vein thrombosis or pulmonary embolism. He further estimates that in the United States alone, at least 100,000 deaths annually occur because of venous thromboembolism. He states that although “we have made progress in our knowledge of how to prevent, diagnose and treat deep vein thrombosis/pulmonary embolism … it is also clear that we are not applying that knowledge on a systematic basis … . To address that gap, we must disseminate information more widely about the availability of effective interventions to prevent and treat deep vein thrombosis/ pulmonary embolism.” Galson also calls for continued investment in basic, clinical, translational, and epidemiologic research related to venous thromboembolism.
      With concerted and coordinated effort, the Surgeon General believes there can be dramatic reduction in the incidence and burden of venous thromboembolism. He predicts that by following the action items listed in the report, tens of thousands of lives each year will be saved in the United States, and suffering will be reduced for many more Americans.
      Advocacy can facilitate public understanding and acknowledgement of the dangers and prevention of disease states such as venous thromboembolism. Advocacy provides patients with a platform to discuss their stories and experiences. It gives government, the public, and health care providers an understanding of deep vein thrombosis and pulmonary embolism and how it can devastate a patient's life and family. With the collaboration of patients, families, clinicians, nonprofit organizations, and government entities such as the Surgeon General's office and the National Heart, Lung, and Blood Institute, the number of people who have a deep vein thrombosis or pulmonary embolism will plummet.

      References

      1. Surgeon General's Workshop on Deep Vein Thrombosis.
        May 8-9, 2006 (Bethesda, MD.) (Accessed February 6, 2009)
      2. The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism.
        (Accessed February 6, 2009)
      3. Fact Sheet: Deep Vein Thrombosis and Pulmonary Embolism.
        (Acessed February 6, 2009)
      4. Your Guide to Preventing and Treating Blood Clots.
        (Acessed February 6, 2009)