Be aware that heparins are of animal origin and this may be of concern to some patients*. For patients who have concerns about using animal products, consider offering synthetic alternatives based on clinical judgement after discussing their suitability, advantages and disadvantages with the patient. [This recommendation is from Venous thromboembolism: reducing the risk (NICE clinical guideline 92)].

* See “Religion or belief: a practical guide for the NHS”, website:
Relative values of different outcomesPlease refer to Venous thromboembolism: reducing the risk (NICE clinical guideline 92). Patient preferences or patient views were the most important outcomes.
Trade off between clinical benefits and harmsPlease refer to Venous thromboembolism: reducing the risk (NICE clinical guideline 92). 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 considerationsNon-applicable
Quality of evidenceNon-applicable
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. If religious beliefs are a source of concern, the patients should be aware of the official stand of religious bodies about the product. Patients will only be able to make a good decision if they have a complete picture of the pros and cons of using these products. Where information is available, it will be useful to direct the patients to these information sources. There is information for patients with specific concerns e.g: “Porcine Derived Products” booklet which is referred to in the Department of Health document titled” Religion or belief: a practical guide for the NHS” (available from http://www​​/en/Publicationsandstatistics​/Publications​/PublicationsPolicyAndGuidance​/DH_093133).
If the relative risks and benefits are explained to the patient and the decisions clearly documented in the patient’s notes, the patient is perfectly within their rights to choose a less effective option, however difficult that might be for the clinician who wants to provide the best care.

From: 11, Patient information

Cover of Venous Thromboembolic Diseases
Venous Thromboembolic Diseases: The Management of Venous Thromboembolic Diseases and the Role of Thrombophilia Testing [Internet].
NICE Clinical Guidelines, No. 144.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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