The ‘4 Ps’ approach to thoughtful testing for thrombophilia
| Patient selection Do not test in patients with provoked venous thromboembolism Testing may be considered in patients with unprovoked venous thromboembolism who express a desire to be tested |
| Pretest counseling Review the implications of testing for and finding a genetic diagnosis with patient and family members |
| Proper test interpretation Ensure appropriate timing of initial and needed follow-up testing (eg, not during acute venous thromboembolism, not while on anticoagulation) Ensure appropriate repeat tests for confirmatory diagnosis of antiphospholipid antibody syndrome |
| Provision of education and advice Provide patients and family with education (at an appropriate health literacy level and in their preferred language) as to what their results mean and how it will affect them now and in the future (eg, nature of the defect, minimal to no impact on life span, role of testing in family members) |
Based on information in reference 26.