Still unmet problems with low molecular weight heparin prophylaxis of venous thromboembolism. An Italian survey

Background: a survey was launched to assess the challenges that Italian patients and physicians face with home prophylaxis using low-molecular-weight heparin (LMWH), promoted by the "Arianna Anticoagulazione" Foundation, Bologna, Italy.Methods: conducted between March and October 2024, the survey targeted readers of the "anticoagulazione.it" website, distributed through a newsletter and social media. There were two different surveys, one addressed to patients/caregivers and the other to physicians.Results: the professional survey revealed significant uncertainties about managing chronic patients, with over half of physicians identifying them as a "gray area." A third of clinicians were unsure about the duration and necessity of home prophylaxis for acute patients. Arbitrary suspension of treatment was reported by a significantly lower proportion of patients/caregivers than professionals (4% vs 38%; p<0.0001).Conclusions: home prophylaxis presents challenges, especially for chronic patients, acute patients treated at home, and those with specific conditions (e.g., renal insufficiency or extreme body weight). The lack of clear guidelines and the widespread use of LMWH outside standard recommendations highlights the need for large-scale clinical trials to address these issues. Discrepancy in compliance reported by patients/caregivers and clinicians underline the need for improved professional-patient communication. *Prof. Gualtiero Palareti passed away on August 8, 2025, prior to publication.