Aim:
This study investigates the scope of VTE in people with UBC in the UK and explores their understanding of VTE from their experience of having cancer and anti-cancer treatments, alongside the perspectives of healthcare professionals (HCPs).

Material and methods:
A sequential mixed-methods study was applied: Phase I, quantitative, exploring the incidence and risk factors for VTE in UBC, by cohort of UK Hospital Episodes Statistics (HES) data and a retrospective case-control analysis using data from two UK NHS trusts. Phase II, semi-structured interviews amongst patients with UBC and HCPs, utilising thematic analysis.

Results:
VTE incidence in people with UBC was around 6.0 per 1000 patients, determined from UK national datasets. Cystectomy and stage IV disease significantly (OR 2.88, 95% CI 1.63-5.07, P<0.001; and OR 4.41, 95% CI 1.85-10.50, P=0.002 respectively), whilst chemotherapy showed borderline statistical significance for risk of VTE (OR 2.56, 95% CI 1.03-6.32, P=0.041). Three major themes emerged from the interviews: ‘all about the cancer’ (thrombosis risk was not a priority for patients with UBC), ‘a labyrinthine process’ (information about VTE was bewildering and compartmentalised) and ‘improving the poor deal’ (suggestions offered to improve communication around VTE were identified).

Conclusions:
VTE is an important clinical problem in patients with UBC. The analysis of this study confirms that the treatment type and metastatic disease are the main risks factors associated with increased VTE risk, HCPs can build on the findings of this study to progress individualised care through multidisciplinary, and patient-centered VTE prevention plans during inpatient encounters.