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RecommendationBase the choice of pharmacological agents on local policies and individual patient factors, including clinical condition (such as renal failure) and patient preferences
Trade off between clinical benefit and harmsDifferent prophylaxis methods have different levels of evidence of efficacy and safety in different populations. Ideally, the choice of agent should be based on the most evidence-based and cost-effective agent for a given population. However, in situations where there are strong patient concerns, these need to be discussed openly.
Economic considerationsWhere a choice of agents is provided within a recommendation this is based either on the results of the cost- effectiveness model for that population, or on the extrapolation of cost-effectiveness results in other populations. In these circumstances the guideline development group were unable to conclusively state which of the strategies were the most cost-effective.
Another of the reasons for local factors to influence choice of drug is that the contract prices (and therefore cost- effectiveness) of some of the drugs vary considerably between NHS Trusts.
Other considerationsWhile it is important to offer patients alternatives if there are concerns about using animal based products, it is also important that patients are aware of the clinical benefits or disadvantages (if any) of using these alternative products. More information is available in Section 32.5.

From: 6, Summary of the effectiveness of mechanical and pharmacological prophylaxis

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Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital.
NICE Clinical Guidelines, No. 92.
National Clinical Guideline Centre – Acute and Chronic Conditions (UK).
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