We are pleased to respond to Dr Spyropoulos' comments on our article "Assessment of Outpatient Treatment of Deep Vein Thrombosis With Low-Molecular-Weight Heparin" and address the issues.
We did not exclude patients with chronic problems such as renal insufficiency, liver disease, malignancy, morbid obesity, pregnancy, or hypercoagulable states because the majority of these patients can be taught to identify signs and symptoms that should be of concern and can have regular blood testing done as an outpatient. Our approach is supported by the overall low rates of adverse events in the study.
Harrison L. Outpatient Protocols for Treatment of Venous Thromboembolism Using Low-Molecular-Weight Heparin: To Treat or Not to Treat at Home. Arch Intern Med. 1999;159(10):1140. doi: