Medical prophylaxis: the value of an “opt in” policy

Medical thromboprophylaxis reduces venous thromboembolism (VTE), while causing bleeding. Routine application of pharmacological VTE prophylaxis to low risk medical patients is likely to cause net harm; as a result only moderate or high risk patients should be exposed to VTE prophylaxis. To avoid unneeded exposure to VTE prophylaxis health care providers should use an “opt-in” policy which does not default to the use of VTE prophylaxis in inappropriate patients.