What follow-up care is recommended for patients who have been treated for pulmonary embolism?

Following treatment for pulmonary embolism (PE), recommended follow-up care includes ensuring adequate monitoring of anticoagulant treatment, providing the patient with an anticoagulant alert card to carry at all times, and giving verbal and written information about their anticoagulation therapy and PE. This information should cover how to use anticoagulants, duration of treatment, possible adverse effects, interactions with other medications, foods, and alcohol, monitoring requirements, effects on dental treatment, considerations for pregnancy, impact on activities such as sports and travel, and when to seek medical help. Patients should also receive verbal and written information specifically about PE, with resources such as the British Lung Foundation website and printable patient leaflets available for support.

For patients with unprovoked PE, a review of medical history and baseline blood tests (including full blood count, renal and hepatic function, prothrombin time, and activated partial thromboplastin time) should be conducted, along with a physical examination if cancer is not already known. Further cancer investigations are not routinely recommended unless clinical symptoms or signs suggest otherwise. If anticoagulation treatment is planned to be stopped, testing for antiphospholipid antibodies and hereditary thrombophilia may be considered in specific cases, such as a family history of venous thromboembolism, but routine thrombophilia testing is not recommended for all patients or their relatives.

Additionally, a plan for monitoring and follow-up should be agreed upon, especially for those treated as outpatients, including providing written information on symptoms and signs to watch for, contact details for healthcare professionals with thrombosis expertise, and information about out-of-hours services. Managing modifiable risk factors such as obesity is also advised.