What is SERENITY and why is it being conducted?

Deprescribing (i.e., discontinuing medication) is an important part of palliative care to prevent polypharmacy, which is associated, among others, with an increased risk of adverse drug reactions, drug-drug and drug-disease interactions, reduced functional capacity, medication nonadherence, and higher healthcare costs. One of the most widely used cardiovascular drug classes in cancer patients are anticoagulants and so-called antiplatelet agents, including direct oral anticoagulants, low-molecular-weight heparins, vitamin K antagonists and antiplatelet agents. Some patients have been receiving these drugs before their cancer was diagnosed, others in order to treat or prevent cancer-related thrombosis. Decisions on deprescribing antithrombotics heavily depend on the indication of the antithrombotic drug, the healthcare professional’s experience as well as the patient’s preference and estimated life expectancy.

So far, however, there is no comprehensive information or guidance that would support healthcare professionals in discussing the issue with their patients and ultimately finding the best personalised solution.

The multinational SERENITY project, funded under the EU HORIZON Research and Innovation initiative (project no. 101057292), aims to develop an information-driven, palliative care shared decision-making process enabled by an easily accessible, web-based shared-decision support tool. The intended tool is meant to facilitate treatment decisions on the appropriate use of antithrombotic therapy in cancer patients at the end of life and it will be designed to be patient-specific in terms of age, sex, type of cancer as well as cultural and socioeconomic factors.

SERENITY takes a comprehensive approach using a combination of methodologies, including a flash mob-design survey, epidemiologic studies, qualitative interviews and a randomised controlled trial.

Understanding current patterns of management of antithrombotic therapy as well as the rationale and preferences behind these patterns is crucial for improving clinical practice. Since deprescribing patterns and rationale may differ across Europe, relevant data at a large scale is needed to fully understand and appreciate the relevant decision-making processes.

SERENITY aims to collect comprehensive data on current practice patterns through a survey among healthcare professionals. Our goal is to enrol at least 800 healthcare professionals from the 8 European countries involved in SERENITY (Denmark, France, Germany, Italy, The Netherlands, Poland, Spain, United Kingdom) and beyond.