VTE Prophylaxis - Who Really Needs It? Who Can Likely Go Without. What Are the Best Options? (2026 CCHM)

Only available as part of a package

Learning Objectives:

Apply Validated Risk Assessment Models to Stratify Medical Patients: Utilize the Padua and IMPROVE scores to assess VTE risk in medically ill patients. Use the Caprini score for surgical patients to balance the risk of thrombosis against bleeding complications.
Compare Prophylaxis Strategies • LMWH vs. UFH: Low Molecular Weight Heparin (LMWH) is generally superior to Unfractionated Heparin (UFH) for prophylaxis, except in patients with severe renal failure (CrCl <30 mL/min). • Mechanical Prophylaxis: Use Intermittent Pneumatic Compression (IPC) or Graduated Compression Stockings (GCS) when pharmacologic prophylaxis is contraindicated due to high bleeding risk.
Implement Updated Cancer-Associated VTE Guidelines • ASCO Updates: Recent guidelines support the use of direct oral anticoagulants (DOACs) like apixaban and rivaroxaban for both the treatment of established VTE and extended thromboprophylaxis in cancer patients. • Bleeding Caution: Exercise caution with DOACs in patients with GI and genitourinary malignancies due to a higher risk of mucosal bleeding.

Timothy J. Barreiro, DO, MACOI

Section Chair Pulmonary, Critical care and Sleep Medicine

NEOMED, LECOM, OUHCOM

Timothy J. Barreiro, DO, MACOI, is a Professor of Internal Medicine whose career reflects a sustained commitment to equity, teaching, and public service. He has spent decades caring for underserved communities and mentoring physicians in training. Hundreds of residents he coached have gone on to fellowships and leadership positions, carrying forward a model of medicine grounded in rigor, accountability, and service.

Dr. Barreiro earned his medical degree from the Ohio University Heritage College of Osteopathic Medicine. He completed fellowship training in pulmonary, critical care at the University of Rochester School of Medicine. In his career, the National Institutes of Health named him a Health Disparities Scholar through the National Center on Minority Health and Health Disparities, recognizing his work on cultural complexity in health care delivery.

His clinical and scholarly focus centers on preventable lung disease and health disparities. He has authored and co-authored more than eighty peer reviewed publications. His work extends beyond academia into public policy and governance. He served as a Health Commissioner for the Ohio Office of Minority Health for over a decade, appointed by the Governor. He currently serves as a Centers for Medicare and Medicaid Services appointee to the Medicare Evidence Development and Coverage Advisory Committee.

Dr. Barreiro is a founding member of the American Osteopathic Association task force on equity and advancement with the ACOI. In Youngstown, Ohio, he leads a multidisciplinary clinic and Program Director for PCCM fellowship that remains the city’s only pulmonary practice serving uninsured patients. He holds leadership and advisory roles in numerous professional societies and has earned the designation of Master Fellow of the College of Osteopathic Interns.

He reads widely in literature and the humanities and writes regularly for DO Magazine. He is a grandfather of two, a role that keeps his professional achievements in proper proportion.

The faculty member, for this activity, has no relevant relationships with ineligible companies to disclose.