SAVTE is A Subsidiary of The PROFILE.

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1 SAVTE is A Subsidiary of The PROFILE

Introduction Saudi Association for Venous Thrombo-Embolism (SAVTE) Increasing awareness to one of the most serious but number one preventive diseases is the cornerstone of Saudi Arabia Venous

2 Introduction Saudi Association for Venous Thrombo-Embolism (SAVTE) Increasing awareness to one of the most serious but number one preventive diseases is the cornerstone of Saudi Arabia Venous Thrombo-Embolism (SAVTE) advisory group. SAVTE was formed on (December 2008) under the umbrella of Saudi Thoracic Society (STS) like the rest of the other groups which include Saudi Advisory for Pulmonary Hypertension (SAPH), Saudi Sleep Medicine Group, Thoracic Surgery Group and TB Group. SAVTE is a non-profit, national organization and its central office is located at STS offices in Jeddah, Kingdom of Saudi Arabia. SAVTE is devoted to increase the awareness and knowledge of Venous Thromboembolism (VTE), and to facilitate advances in the treatment of affected people, as well as the routine implementation of thromboembolism prophylaxis measures among Health Care Providers within the Kingdom of Saudi Arabia. SAVTE will function as a think tank that will provide expertise to advise physicians, scientists, health authorities and the whole healthcare industry regarding medical technologies and pharmaceuticals relevant to VTE. We have a special responsibility to disseminate knowledge and information on VTE and to conduct local lectures, workshops, symposia and medical meetings, for we believe it is through education that we hope to make a lasting impact on improving the quality of life of our people. For more information about SAVTE, please visit our website at: F Alhameed Fahad M Al-Hameed, MD, FCCP, FRCPC Chairman, Saudi Association for Venous-Thrombo-Embolism (SAVTE)

VTE Current and Future Trends VTE is recognized as a major public health issue Venous Thrombo-Embolism is considered one of the highest risk for hospitalized and community patients.

In the literature, 60 70 % of DVT cases were clinically undiagnosed and only detected at autopsy. At least 70 % of fatal PE detected post mortem was neither suspected nor diagnosed pre mortem.

3 VTE Current and Future Trends VTE is recognized as a major public health issue Venous Thrombo-Embolism is considered one of the highest risk for hospitalized and community patients. The in hospital case fatality rate of VTE ranged between %. Around 10 % of hospital deaths are due to PE, and 1 % of all hospital admissions died from PE. In the literature, % of DVT cases were clinically undiagnosed and only detected at autopsy. At least 70 % of fatal PE detected post mortem was neither suspected nor diagnosed pre mortem. PE is the most common preventable cause of hospital deaths. Appropriate use of prophylaxis for VTE in patients at risk is the number one strategy to improve patient safety in the hospitals. Therefore, appropriate use of thromboprophylaxis should reduce adverse patient outcome and decrease overall cost. All hospitalized patients, 14 years and above should be screened and assessed for their venous thrombo embolic risk and should receive subsequent prophylaxis. Early ambulation should be considered for all patients as soon as the clinical condition permits. For each of pharmacologic agents, clinician should consider the manufacturer s suggested dosing guidelines. For each patient, the benefits of starting pharmacologic prophylaxis should be weighed against the risk of bleeding. Mechanical methods (Intermittent Pneumatic Compression and/or Graduated Compression Stockings (GCS)) of prophylaxis should be used primarily in patients who are at high risk of bleeding or as an adjunct to pharmacologic prophylaxis. F Alhameed Fahad M Al-Hameed, MD, AmBIM, FCCP, FRCPC Consultant Critical Care & Pulmonary Medicine Deputy Chairman of Intensive Care Department Chairman of Saudi Association for Venous-Thrombo-Embolism (SAVTE) King Khalid National Guard Hospital King Abdulaziz Medical City Kingdom of Saudi Arabia In December 2008 STS calls to formulate Saudi Arabian VTE Advisory Group SAVTE Group VTE: Magnitude of the Problem in Saudi Arabia DEATH PE Post-thrombotic Syndrome Symptomatic DVT Asymptomatic DVT 15,000-20,000 60,000 80, ,000 1-Aboelnazar E, Alhameed F, Galal S ; VTE related mortality and morbidity, Abstract. Thrombosis, Milan, July 6-9, Igbinovia A, al-shehri MY. DVT in Assir region of Saudi Arabia. Angiology Dec;46(12):

Mission Structures The Saudi Association for Venous Thromboembolism (SAVTE) is a medical and research body that is considered as a part of the Saudi Thoracic Society (STS) and is devoted to increase

4 Mission Structures The Saudi Association for Venous Thromboembolism (SAVTE) is a medical and research body that is considered as a part of the Saudi Thoracic Society (STS) and is devoted to increase the awareness and knowledge of Venous Thrombo-Embolism (VTE), and to facilitate advances in the treatment of affected people, as well as the routine implementation on thrombo- embolism prophylaxis measures among Health Care Providers (HCP) within the Kingdom of Saudi Arabia. Organization The SAVTE is a non-profit, national group whose directors, executive officers and members receive no salary. It is registered and operates under the STS. Its central office is located at STS offices in Jeddah, Kingdom of Saudi Arabia. SAVTE Administrative Office is part of STS and is headed by the Head of the STS. The administrative staff is dedicated and salaried by STS SAVTE Executive Committee: An Executive Committee will be formed from the Executive members. This Committee shall be comprised of: 1. SAVTE Head, who serves for 3 years but can be re-elected. This is a non-salaried position providing strategic leadership for SAVTE. The Institute Head shall serve as Chair of the Executive Committee. 2. SAVTE Vice-Head, who serves for 3 years, but can be re-elected. This is a non-salaried position that assists the Head and covers him during his absence. He also should execute policies of SAVTE. 3. Managing Director. This is a non-salaried position, has the responsibilities of running the day to day activities and monitoring all task forces work. He should serve for 3 years but can be re-elected once. 4. Eleven To Thirteen elected Senior Executive Members chosen from the Executive members. These will be for a four year term with 3 members chosen every two years. Their main tasks are to support the work of the Executive Committee In his/her absence, the chair of the executive committee will be taken by the Vice Head. In the absence of both the Head and the Vice Head, the members of the committee present shall elect an acting chairperson Nominations for election to the Head, Vice Head, and Managing Director of the Executive Committee shall be supported by at least three members and submitted in writing to the Committee Head at least three months before the annual business meeting Members of the Executive Committee who retire before the end of their term may be replaced by co-option at the discretion of the remaining members of the Executive Committee Seven members of the Executive Committee shall constitute a quorum The Executive Committee is responsible for: 1. Initiating and overseeing SAVTE activities 2. Approving the Taskforces and Taskforce Leaders 3. Approving membership 4. Establishing meetings 5. Ensuring appropriate consultation with SAVTE members on strategy, policy and changes to the constitution 6. Enforcing the disciplinary code 7. Vacancies: If a vacancy for any of the officers occurs for any cause it shall be filled within 30 days by election by the Council of Executive members

SAVTE Executive Members Objectives Dr. Fahad Al Hameed Pulmonary / ICU Deputy Chairman, Intensive Care Department Chair of SAVTE KAMC- Jeddah Prof.

Mohammed Addar Gyn Chairman of OB/Gyne Department KKUH-Riyadh Dr. Esam Abo El Nazer General Surgeon Head of Liver Surgery Section KFGH-Jeddah Dr.

5 SAVTE Executive Members Objectives Dr. Fahad Al Hameed Pulmonary / ICU Deputy Chairman, Intensive Care Department Chair of SAVTE KAMC- Jeddah Prof. Mohamed Al Hajjaj Consultant Pulmonologist Professor of Pulmonary Medicine Respiratory Division, Medicine Department President, Saudi Thoracic Society KKUH-Riyadh Dr. Mohammed Addar Gyn Chairman of OB/Gyne Department KKUH-Riyadh Dr. Esam Abo El Nazer General Surgeon Head of Liver Surgery Section KFGH-Jeddah Dr. Abdulelah Qadi Haematologist Head of Haematology KFGH-Jeddah Dr. Hasan Al Dorzi Pulmonary/ ICU Director of Medical ICU KAMC-Riyadh Dr. Majdy Idrees Consultant Pulmonologist Head of Pulmoary Section Chairman of SAPH group RKH-Riyadh Dr. Tariq Al Khuwaitir Internal Medicine Chairman of Internal Medicine Department KSMC Dr. Fawzi Al Jassir Orthopedic Associate Professor Head of Orthopedic Section KKUH-Riyadh Dr. Shemaylan Al Harbi Clinical Pharmacist KAMC-Riyadh Dr. Mohamad Abdelaal Haematologist Chairman of Haematology Pathology Department KAMC- Jeddah To perform joint multicenter research on the local incidence, prevalence, and pathphysiology of VTE in Saudi Arabia. To identify and investigate the unique characteristics of the illness including its morbidity and mortality. To focus on improving prevention & treatment of VTE, by promoting research, and assisting the development and conduct of clinical trials according to the highest standards for clinical research. To provide expertise to areas with healthcare disparities that will address issues related to the education and training of healthcare professionals in the field of VTE by means of local lectures, workshops, symposia and medical meetings. To disseminate knowledge and information on VTE to educate practicing physicians on the best and updated information by producing a local guidelines on diagnosis and treatment of VTE. To establish effective preventive measures and therapies, accessible to the affected patients using well prepared brochures and other media. To provide consultative services to health agencies and industry regarding advancing the treatment of VTE. Former Members Dr. Mohamed Hijazi Chairman of ICU Director of Quality Improvement KFSH&RC Dr. Soror Al Aithan Pulmonary/ICU Head of ICU DCH- Dammam Dr. Yaseen Arabi Pulmonary/ ICU Chairman of ICU KAMC- Riyadh

6 Membership Membership Cont. Membership is open to all with an active research and/or educational interest in VTE disease and related fields. However, the membership should be addressed through the main society, i.e. the STS. The SAVTE recognizes 3 categories of membership General members who may or may not be STS members. Special members (who work within the taskforce groups) Executive Committee members General Members: Open to anyone with an interest in VTE disease May be conferred at any time Must submit STS application and payment of annual dues Membership will be renewed annually by receipt of payment of dues. All members shall pay an annual subscription of an amount to be determined by the Executive Committee Membership shall automatically be suspended if the member fails to meet any obligation or make owed payments due to STS. Suspension shall continue until such obligations are met or all sums due to the STS are paid, whereupon such privileges may be reinstated by the Executive Committee In special circumstances, dues may be waived by the Executive Committee. Membership benefits: i. Access to the restricted area of the SAVTE website ii. Eligible for participation in SAVTE sponsored symposia and meetings iii. Reduced fees for the SAVTE educational meetings and training sessions. Special Members: Must have a degree (MS, MD, PhD, RN) May be nominated by executive members at any time Must submit application and payment of annual dues May be conferred at any time by Executive Committee Must participate in at least one taskforce Have all entitlements of membership Executive Members: Are elected in recognition of a substantial contribution to the understanding and treatment of VTE disease and related fields throughout their career. Nominations for executive membership shall be made in writing to the chairman of SAVTE before the periodic business meeting. Each nomination shall be accompanied by a statement of the academic qualifications, professional position and a list of relevant publications and potential contribution to the SAVTE mission. The chairman of SAVTE will select nominees to be presented for election to Senior Fellowship at the periodic business meeting. Membership is confirmed by a simple majority of those voting in favor Must submit application, conflict of interest form, copy of C.V, and the annual dues payment Take responsibility as leader or co-leader of SAVTE Taskforces Are responsible for the maintenance of SAVTE educational materials Have all entitlements of membership and can be elected for Executive Committee membership Taskforces The Executive Council (EC) will have the authority to create taskforces whose responsibility will be to provide oversight to the specific activities within the SAVTE. Taskforces will be created along the following three general categories: 1. Disease focused: Targeted to a disease that is associated with VTE which affects relatively large numbers of patients in underserved areas 2. Region focused: Targeted to a region with health disparities in areas of VTE 3. Education focused: Targeted to activities which will help increase knowledge and expertise about VTE Each taskforce will have: 1. The Executive Committee will select one of its members as a leader of one of the taskforce groups 2. A steering committee selected by the leader of the taskforce from outside the EC 3. There is no limit to number of taskforces, size of taskforce membership and the duration of taskforce activities 4. Taskforces must present an annual report to the Executive Committee

SAVTE Website Activities The SAVTE will address its objectives primarily by the establishment of focused taskforces that will design and conduct projects across the broad which include research,

The website will be maintained by the administrative staff of the SAVTE /STS The SAVTE dedicated website will provide unrestricted information on all members, including their current curriculum vitae

7 SAVTE Website Activities The SAVTE will address its objectives primarily by the establishment of focused taskforces that will design and conduct projects across the broad which include research, education and clinical care related to VTE diseases. The website will be maintained by the administrative staff of the SAVTE /STS The SAVTE dedicated website will provide unrestricted information on all members, including their current curriculum vitae and conflicts of interests, information on the current activities and ongoing projects of the Associations and the Institutes The website will provide restricted access to educational materials and commentaries provided and maintained by the Executive Members SAVTE website will host a consolidated syndicated summary database based on individual databases of affiliated centers. In addition, there will be individual databases for VTE created in the developing countries or specific to certain diseases The web site will host a web based, multilingual articles on VTE Disease written by the SAVTE members The activities of the SAVTE include, but are not limited to the following: The SAVTE will function as a think tank and provide expertise to advise physicians, scientists, health authorities and the healthcare industry regarding medical technologies and pharmaceuticals relevant to VTE The SAVTE will establish a national database on patients with VTE to allow a meaningful understanding of the similarities and differences in the spectrum of the illness between different regions in the kingdom and other countries in the world The SAVTE will develop web-based, multilingual educational materials, advice and guidelines on the management of VTE disease accessible to people involved in healthcare delivery The SAVTE will conduct workshops on the modern methods to evaluate patients, determine accurate diagnoses, and monitor the efficacy of treatments The SAVTE will conduct periodic national and regional symposia to disseminate information acquired from the SAVTE activities, and identify research projects relevant to its activities

The experts weigh in on Thromboprophylaxis First SAVTE Publications PE is the most common preventable

strategy to improve patient safety in hospitals Appropriate use of thromboprophylaxis should reduce

80% without Symptoms Diagnosis of VTE VTE is often undetected until too late (all pts) The First Saudi

nor diagnosed 1,2 30% At autopsy, 63% of DVT cases were clinically undiagnosed 2 70% unsuspected 1.

8 The experts weigh in on Thromboprophylaxis First SAVTE Publications PE is the most common preventable cause of hospital death Appropriate use of prophylaxis for VTE in patients at risk is the number 1 strategy to improve patient safety in hospitals Appropriate use of thromboprophylaxis should reduce adverse patient outcomes and decrease overall costs Most VTE/DVT cases are not detected 20% with Symptoms 80% without Symptoms Diagnosis of VTE VTE is often undetected until too late (all pts) The First Saudi Arabian VTE Hospital Based Registry At least 70% of fatal PE detected postmortem was neither suspected nor diagnosed 1,2 30% At autopsy, 63% of DVT cases were clinically undiagnosed 2 70% unsuspected 1. Stein and Henry. Chest. 1995;108: Sandler and Martin. J R Soc Med. 1989;82:

The following local hospitals already are willing to participate through their representative members (COORDINATING PHYSICIAN): King Fahad General Hospital, Jeddah (Dr.

9 The First Saudi Arabian VTE Hospital Based Registry The Largest National Saudi Arabian VTE Registry Dr. Fahad Al Hameed & Prof. Esam Abo El Nazer are working in a project to expand this registry to include many Hospitals in the kingdom and may be gulf and Middle East region. The following local hospitals already are willing to participate through their representative members (COORDINATING PHYSICIAN): King Fahad General Hospital, Jeddah (Dr. Qadi) King Faisal Specialist Hospital & RC, Riyadh (Dr. Jalal) KAMC (NG), Jeddah (Dr. Fahad) KAMC (NG), Riyadh (Dr. Hassan) King Saud Medical City, Riyadh (Dr. Tariq) King Khalid University Hospital (Dr. Farjah) Military Hospital, Complex, Riyadh (Dr. Majdy) King Abdel Aziz University, Hospital Jeddah (Dr. Galilah) An Outstanding VTE Awareness Days (Meeting) Conducted in the following places King Saud Medical Complex in Riyadh King Saud U Hospital in Riyadh King Abdul Aziz U Hospital in Jeddah King Abdul Aziz Medical City (NG) Riyadh X3 King Abdul Aziz Medical City (NG) Jeddah X2 King Fahad General Hospital in Jeddah X3 Maternity General Hospital in Jeddah Tabuk Military Hospital in Tabuk X3 Taif Military Hospital in Taif Al-Noor Specialist Hospital Makkah X3 King Fahad Specialist Hospital Dammam Others

10 VTE Awareness Day The 1st International Conference for Venous Thrombo-Embolism by SAVTE

11 VTE Prevention Guidelines Booklet Educational Booklets

12 Conclusion VTE is a preventable public-health crisis. All medical patients admitted to the hospital should be assessed for VTE, and those at moderate or high risk should receive prophylaxis. Increase in Awareness Increase in Practice Increase in Quality of Life Decrease in Healthcare Costs

Policy for Venous Thromboembolism Prevention and Treatment

Policy for Venous Thromboembolism Prevention and Treatment Start date: May 2013 Next Review: May 2015 Committee approval: Endorsed by: Distribution: Location Thrombosis and Thromboprophylaxis Steering