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Tracking Awareness Of Venous Thromboembolism Among The General Population

Tracking Awareness Of Venous Thromboembolism Among The General Population. Final Report Prepared for the International Society on Thrombosis and Haemostasis Prepared by Ipsos Healthcare Updated September 4, 2014. Table of Contents. Background, Objectives, Methodology. 3. 45. Individual

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Tracking Awareness Of Venous Thromboembolism Among The General Population

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  1. Tracking Awareness Of Venous Thromboembolism Among The General Population Final Report Prepared for the International Society on Thrombosis and Haemostasis Prepared by Ipsos Healthcare Updated September 4, 2014

  2. Table of Contents Background, Objectives, Methodology 3 45 • Individual • Country Reports: • US (slide 46) • UK (slide 64) • Canada (slide 82) • Germany (slide 100) • Argentina (slide 118) • Netherlands (slide 136) • Thailand (slide 154) • Australia (slide 172) • Japan (slide 190) 6 Sample/Weighting Schematic 9 Overall Results 16 Overview of Country Findings 19 Supporting Data for Country Findings

  3. Background, Objectives, and Methodology

  4. Background • The International Society of Thrombosis and Haemostasis (ISTH), along with a variety of organizations, has established the first annual World Thrombosis Day to stop preventable deaths worldwide. • Beginning in 2014, World Thrombosis Day will be observed annually on October 13 – Rudolf Virchow’s birthday. • In order to raise awareness and make the first World Thrombosis Day a success, supporters have suggested conducting and releasing results from a global survey on public awareness of the risks of venous thromboembolism (VTE). • Results from this survey will serve as a baseline for public awareness of VTE which the ISTH and its stakeholders can leverage to assess progress of their efforts year over year.

  5. Objectives and Methodology Objectives Main Objective: To conduct a global quantitative research study to assess awareness of VTE. Research Objectives: • Establish a baseline awareness level against which ISTH can measure progress year after year • Create media angles that ISTH’s public relations team and in-country partners can use to generate coverage • Generate a body of knowledge that could be the springboard for articles in academic journals (secondary objective) • Between July 22 and August 5, 2014 Ipsos conducted five-minute-long online surveys among adults at least 18 years of age in the Americas, European Union, and Asia Pacific. Surveys were translated into each native language accordingly. • Respondents were previously recruited on internet panels and opted-in to do online research. Invitations were sent via email and respondents participated via a link in the email. No additional solicitation was needed to complete the research quotas. Methodology Sample Plan Statistical testing was performed at the 95% confidence interval. Statistical differences are noted on each individual chart throughout the report. • *Fielding in Thailand did not allow for specified sample breakout among ages 65+, though some respondents do fall into this category. The older generation is less likely to be online, especially in countries where cultural differences exist as well. • Analytics Note: • The report findings are weighted to population sizes based on the most recent census data for each country

  6. Sample/Weighting Schematic • Recruitment was conducted online only as was best case scenario. Reasonable assumptions can be made about respondents who have substantial online capabilities, specifically in less developed countries and among older age groups. • The sample has been weighted based on recent census data for each country. This allows for analysis to be made in relation to the country’s actual population. *Initial sample was for n=640 over age 40, however 65+ sample was sufficient to break out. For reference: Males > 65 years old = 6% Females >65 years old = 7%

  7. Overall Study and Analytical Notes Sample sizes in each country were identified to provide the opportunity to test the differences among groups with traditional levels of statistical error (alpha = .05) and provide estimates with 95% confidence intervals for country level reporting of approximately +/- 3.5% margin of error. Larger samples would have yielded confidence intervals that were smaller (more precise estimates), but the costs of doing so would have substantially impacted the costs of the research. Statistical differences are noted by capitalized alphabetical letters next to data presented throughout the project. Sample Ipsos Healthcare abides by the research quality guidelines of the Council of American Survey Research Associations (CASRO). As such the research was conducted utilizing procedures that are aspired to by the highest quality organizations in the survey research field. Information collection, analysis and reporting conform strictly to CASRO standards and are described on the CASRO website (www.CASRO.org) with the title “Code of Standards and Ethics for Market, Opinion, and Social Research”. Any research agencies which have provided assistance to Ipsos Healthcare in the conduct of this research follow these same guidelines in the performance of their work for the project. Quality Standard Online Methodology Every practical effort was made to have the surveys completed by a representative sample of the target population in each country.  It should be noted, however, that there are logistical issues that restrict researchers abilities to get perfectly representative samples from target populations in any survey research.  In this instance, while an internet survey was identified as the best practical means of implementing this survey with reasonable cost, internet access varies for the target population by country of interest. 

  8. Overall Study and Analytical Notes The research reported was implemented through the use of a unified research design, with the basic questionnaire being translated into the appropriate language for each country included in the study.  The translation effort includes translating from English to the other languages and is followed by a “back-translation” wherein the translated questionnaire is translated back to English in order to identify any issues of confusion relating solely to the translation itself. Despite the efforts to assure clarity and accuracy of translations, some differences in findings between countries  may occur due to the “response styles” of respondents in those countries.  The utilization of rating scales or responses to “yes/no” questions may vary between countries simply for cultural/response style reasons. For the sake of clarity, the findings are provided here exactly as they were reported by respondents in all countries.   While Ipsos believes that the use of computation systems to “correct” for cultural/response style differences can be applied to this issue (see:  Standardization to Account for Cross-Cultural Response Bias: A Classification of Score Adjustment Procedures and Review of Research in JCCP Journal of Cross-Cultural Psychology May 2004 35: 263-282), as there is not solid agreement among survey practitioners as to the most accurate adjustment system, we believe it would not be beneficial for a study that is expected to serve as a benchmark for subsequent research, where all subsequent waves would require adjustment.  The recommendation is to keep in mind the potential for cross-cultural response bias, but also note that tracking individual countries over time will allow for the identification of changes within each country, even though cross-country comparisons may occasionally be problematic.  Multi Cultural Nature

  9. Overall Results • Analytics Note: • The report findings are weighted to population sizes based on the most recent census data for each country

  10. ON AVERAGE, AWARENESS OF THROMBOSIS IN COUNTRIES STUDIED IS SIGNIFICANTLY LESS THAN OTHER COMMON-PLACE MEDICAL CONDITIONS AVG. CLAIMED AWARENESS MEDICAL CONDITION Countries of Study Netherlands Thailand Australia Japan United States Canada Argentina United Kingdom Germany

  11. AWARENESS OF THROMBOSIS, DEEP VEIN THROMBOSIS, AND PULMONARY EMBOLISM VARIES WITHIN COUNTRIESAS WELL AS AMONG COUNTRIES THROMBOSIS UK has most awareness. 1. DE 82% 2. UK 80% 3. NL 77% 4. AR 70% 5. TH 68% 5. AU 68% 7. JP 59% 8. US 52% 8. CA 52% Japan has least awareness. 2 1 3 1 1 3 DEEP VEIN THROMBOSIS PULMONARY EMBOLISM 1. UK 86% 2. AU 80% 3. US 57% 4. CA 41% 5. DE 38% 6. AR 33% 7. TH 24% 8. NL 20% 9. JP 13% 1. UK 72% 1. NL 72% 3. US 70% 4. AR 66% 5. CA 63% 6. AU 57% 7. JP 31% 8. TH 30% 9. DE 23% 1 3 2

  12. NEED FOR VTE EDUCATION EXISTS AROUND THE WORLD* 81% An average of 81% of respondents do not know what a pulmonary embolism would feel like if they had one personally. VTE 72% An average of 72% of respondents do not know what a deep vein thrombosis would feel like if they had one personally. Risk Factors 55% An average of 55% of respondents do not know that a blood clot can be prevented. 39% An average of 39% of respondents do not know a blood clot in a vein is the underlying cause of deep vein thrombosis. *Defined as countries tested in this research

  13. CANCER, HOSPITAL STAYS, AND RECENT SURGERY ARE LESS OFTEN CONSIDERED RISK FACTORS FOR BLOOD CLOTS 16% • Among countries measured, an average (mean) of 16% of respondents considered CANCER • a risk factor for blood clots 25% • Among countries measured, an average of 25% of respondents considered HOSPITAL STAYS • a risk factor for blood clots 36% • Among countries measured, an average of 36% of respondents considered SURGERY • a risk factor for blood clots

  14. Appendix: Aggregate Country Findings • Analytics Note: • The report findings are weighted to population sizes based on the most recent census data for each country

  15. Aggregate Country Summary of Results Claimed awareness of thrombosis varies from country to country. • Awareness of the singular term “thrombosis” is highest in Germany (82% of adults 18+) and the United Kingdom (80%). The least thrombosis-aware countries are Canada (52%) and the United States (52%). • Awareness of deep vein thrombosis is highest in the United Kingdom (86%) and Australia (80%) and awareness of this condition is actually higher than thrombosis in the singular, in these countries. Japan has the lowest awareness (13%) of deep vein thrombosis. • Awareness of pulmonary embolism is highest in the United Kingdom (72%) and the Netherlands (72%). • Adults in both the U.S. and in Canada are more aware of pulmonary embolism compared to thrombosis. Personal concern for medical conditions, in general, is highest in Argentina and Thailand while lowest in the Netherlands. • As with other medical conditions, concern for thrombosis is also highest in Argentina and Thailand where more than half of those aware of thrombosis, deep vein thrombosis, and pulmonary embolism are concerned about each condition. • In all other countries, approximately one-third or less of those aware of each thrombosis term are personally concerned about the condition. Adults in the United Kingdom and Australia are most able to indicate the underlying cause of a deep vein thrombosis. • 80% of English adults and 76% of Australian adults correctly indicate a blood clot in a vein is the cause of DVT. • Nearly two-thirds of adults in Germany (66%), the Netherlands (64%), and Thailand (58%) indicate the correct cause. • In all other countries, approximately half of the adult population are able to correctly indicate the cause of DVT.

  16. Aggregate Country Summary of Results Compared to those knowing the cause, a smaller proportion of adults in each country claim to know what a deep vein thrombosis would feel like. • In the majority of countries, approximately one-fourth of the adult population claimed to know what a DVT would feel like. • Claimed knowledge is highest in Thailand (51%) and lowest in the Netherlands (15%). Swelling and pain or tenderness in the leg are the most well-known symptoms of DVT. • In all countries, swelling of the leg and pain/tenderness in the leg were the most commonly selected symptoms of DVT. • The most commonly misidentified symptom of DVT is leg paralysis. Compared to deep vein thrombosis, even fewer adults are aware of what a pulmonary embolism would feel like. • As with DVT, Thai adults claim to be most aware of pulmonary embolism symptoms (44% of adults). • Among the remaining countries, less than one-fourth of the adult population claim to know what a pulmonary embolism would feel like. Shortness of breath and chest pain are the most well-known symptoms of PE. • In all countries, shortness of breath and chest pain were the most commonly selected symptoms of a PE. • Half or nearly half of adults whom claimed to know what a PE would feel like incorrectly selected slow, shallow breathing as a PE symptom.

  17. Aggregate Country Summary of Results The most commonly perceived risks for developing blood clots include not moving for long periods of time and a family history of blood clots. • Older age is also a very popularly perceived risk factor. • The most common misperceptions about blood clots are that those with high cholesterol and high blood pressure are at higher risk. Most adults in each country agree, blood clots are a medical emergency and can cause death. • Among the statements/facts regarding blood clots, some of the most polarizing results among countries include: • The Thai are most likely to feel people under 40 do not need to worry about blood clots (15%). • Only 20% of adults in the Netherlands feel that blood clots can be prevented. • 38% of adults in Thailand believe it is unlikely an untreated blood clot in the leg can travel to the lungs, more than double that of any other country. • In Thailand (51%) and Japan (56%), adults are less likely to consider blood clots a medical emergency.

  18. Aided Awareness of Various Medical Conditions Among Adults 18+ BREAST CANCER STROKE HIGH BLOOD PRESSURE HEART ATTACK CDEFG CDEFG CDEFG CDEF DEFG CDEFG CDEFG EF DEFG E E EFG MEAN MEAN MEAN MEAN MEAN G 87% 85% 85% 88% 90% CDEFGHI BCDEFGHI CDEFG DEFG DEFG DEFG DEF DEF DEFG DEFG EF E G G AIDS CDEFGI CDEFGI DEF DEF DEF DEF Base: All Respondents. Q1. For each medical condition or term listed, indicate if you are aware of or have ever heard the term. *Aided Awareness indicates respondents were shown a list of terms from which to select their response.

  19. Aided Awareness of Various Medical Conditions Among Adults 18+ PROSTATE CANCER PULMONARY EMBOLISM THROMBOSIS DEEP VEIN THROMBOSIS HEMO-DISTENSION SYNDROME* CDEFG CDEFG DEFG DEFG DEFG ABCDEFGI MEAN MEAN MEAN MEAN MEAN DE ACDEFGI DE 82% 54% 68% 10% 44% D ACDEFG AEFG EFG EFG E E ABCEFGI ABCEGI ABCEGI CEI CEI CEI CI ABCDEFHI BCDEFHI CEFHI CEF EF EF E *Fictitious disease for reference of over-agreeance ABCDEG BCDEG BCDEG BDEG BDEG DEG D D Base: All Respondents. Q1. For each medical condition or term listed, indicate if you are aware of or have ever heard the term. *Aided Awareness indicates respondents were shown a list of terms from which to select their response.

  20. Aided Awareness of Various Medical Conditions Among Adults 18+ United States (A) Canada (B) Argentina (C) United Kingdom (D) Germany (E) BEFGI BEFI EFGI EFI EFI EFI BEFGI EFGI EFGI EFGI BEFGI EFGI ABCGHI BEGHI BEGHI ABCEFGHI BCEFGI I I I EFI EFI G FGI G EFGI EFGI ABCFGHI EGHI CFGI FGI BEFGI ABDEFGI ABEFGI EFGI ABDEFGHI EFGI ABI EGHI FGI Base: All Respondents. Q1. For each medical condition or term listed, indicate if you are aware of or have ever heard the term. *Aided Awareness indicates respondents were shown a list of terms from which to select their response.

  21. Aided Awareness of Various Medical Conditions Among Adults 18+ Netherlands (F) Australia (H) Thailand (G) BEFI FI BEFGI ABEFGI BEFGI EFGI G BEFGI EI ABI ABCGHI EGI BCEGHI ABCEFGI I Japan (I) FI FI EFI EI E ABI AB E E I Base: All Respondents. Q1. For each medical condition or term listed, indicate if you are aware of or have ever heard the term. *Aided Awareness indicates respondents were shown a list of terms from which to select their response.

  22. Personal Concern for Various Medical Conditions Among Adults 18+ Aware of Condition Top 2 Box Results HIGH BLOOD PRESSURE STROKE BREAST CANCER* AIDS HEART ATTACK MEAN MEAN MEAN MEAN MEAN BCDEFGHI 44% 42% 48% 20% 44% ABCDEFHI BCDEFHI BCDEFHI BDEFHI BDEFH DEFH F F DF F F F F F F BCDEFGHI BCDEFGHI BCDEFHI BCDEFHI DEFI EFI BDEFH DEFH F EF EF F F EF F *Among Females Only. BCDEFGHI BCDEFHI EFH EF EF EF EF Base: Respondents aware of condition at Q1. Q2. On a scale of 1 to 5, how concerned are you about each of these medical conditions? (Where 1 is not at all concerned and 5 is extremely concerned about risk to your health.)

  23. Personal Concern for Various Medical Conditions Among Adults 18+ Aware of Condition Top 2 Box Results PROSTATE CANCER* PULMONARY EMBOLISM THROMBOSIS DEEP VEIN THROMBOSIS MEAN MEAN MEAN MEAN 29% 31% 41% 28% BCDEFGHI BCDEFHI BCDEFHI BCDEFHI DEFH DEF DEF F F F F F F F F F *Among Males Only. BCDEFHI BCDEFHI BCDEFHI BCDEFHI BFHI BCFHI BF F BFI F F F Base: Respondents aware of condition at Q1. Q2. On a scale of 1 to 5, how concerned are you about each of these medical conditions? (Where 1 is not at all concerned and 5 is extremely concerned about risk to your health.)

  24. Personal Concern for Various Medical Conditions Among Adults 18+ Aware of Condition Top 2 Box Results United States (A) Canada (B) Argentina (C) United Kingdom (D) Germany (E) FI DEFI F DEFHI F EFI AFI F F F F F F F FI FI FI DEFHI F DEFI DEFI F F AEFI F ADEFHI F F FH F AFH DFI FI Percentage represents “Top 2 Box Score” the percent of respondents that selected 4 or 5 ABDEFGHI ABDEFHI ABDEFGHI ABDEFGHI ABDEFGHI ABDEFHI Not at All Concerned ExtremelyConcerned 1 2 3 4 5 ABDEFHI ABDEFHI ABDEFGHI Base: Respondents aware of condition at Q1. Q2. On a scale of 1 to 5, how concerned are you about each of these medical conditions? (Where 1 is not at all concerned and 5 is extremely concerned about risk to your health.)

  25. Personal Concern for Various Medical Conditions Among Adults 18+ Aware of Condition Top 2 Box Results Netherlands (F) Japan (I) Australia (H) Thailand (G) FI EF EFI F F F F FI FI ABDEFHI ABCDEFHI F ABDEFHI F ABDEFHI ABDEFHI F F ABDEFHI ABDEFHI ADFH ABDEFHI ABDFH ABDEFHI Percentage represents “Top 2 Box Score” the percent of respondents that selected 4 or 5 Not at All Concerned ExtremelyConcerned 1 2 3 4 5 Base: Respondents aware of condition at Q1. Q2. On a scale of 1 to 5, how concerned are you about each of these medical conditions? (Where 1 is not at all concerned and 5 is extremely concerned about risk to your health.)

  26. Perceived Underlying Cause of a Deep Vein Thrombosis Among Adults 18+ in Each Country ABCDEFGI ACDEFGI CEFGI CEFGI EF EF ABDEGH ABDGH ABDH BDH BDH BDH BH DH ABCDFGHI ACEFHI ABC GHI ABC GH EH EH E E E A BD BD BD A D A blood clot in a vein Lack of oxygen in a vein A tumor in a vein None of the above Unsure Base: All Respondents. Q3. Which of the following phrases best describes the underlying cause of a deep vein thrombosis? (select one)

  27. Knowledge of Deep Vein Thrombosis Symptoms Proportion of Adults 18+ which Claim to Know What a DVT Would Feel Like BCDEFGHI CDEFGHI I I I I I I Base: All Respondents. Q4. Do you know what a blood clot in your leg (also known as deep vein thrombosis) would feel like if you had one personally?

  28. Perceived Symptoms of Deep Vein Thrombosis Among Adults 18+ Claiming to Know What DVT Feels Like LEG FEELS WARM TO TOUCH SWELLING OF LEG CHANGES IN SKIN COLOR OF LEG PAIN/TENDERNESS OF LEG ACTUAL SYMPTOMS OF DVT MEAN MEAN MEAN MEAN 81% 61% 76% 44% EG EG EG EG EG G BCDEGH G BEG ACEG ACEG AEG EG EG EG EG AEG AEG AEG AEG EG EG EG Base: Respondents aware of symptoms at Q4. Q5. Please indicate the signs or symptoms of a blood clot in your leg (also known as deep vein thrombosis). (select all that apply)

  29. Perceived Symptoms of Deep Vein Thrombosis Among Adults 18+ Claiming to Know What DVT Feels Like NONE OF THE ABOVE ITCHING OF LEG LEG PARALYSIS NOT SURE OTHER INACCURATE SYMPTOMS OF DVT MEAN MEAN MEAN MEAN MEAN 32% 0% 22% 2% 1% ABCDEFHI ACDFHI DFG AFH DFG DFG A FG FG F A A BCDF Base: Respondents aware of symptoms at Q4. Q5. Please indicate the signs or symptoms of a blood clot in your leg (also known as deep vein thrombosis). (select all that apply)

  30. Perceived Symptoms of Deep Vein Thrombosis Among Adults 18+ Claiming to Know What DVT Feels Like United States (A) Canada (B) Argentina (C) United Kingdom (D) Germany (E) GI GI CGI GI GHI CGI CGI FG F C GI GI GI GI CGI CGI EFG C C Actual DVT Symptom GI GI Incorrect DVT Symptom BDEGHI GI Other/None/Not Sure FG Base: Respondents aware of symptoms at Q4. Q5. Please indicate the signs or symptoms of a blood clot in your leg (also known as deep vein thrombosis). (select all that apply)

  31. Perceived Symptoms of Deep Vein Thrombosis Among Adults 18+ Claiming to Know What DVT Feels Like Netherlands (F) Australia (H) Thailand (G) Japan (I) GI GI BCGI BCGI CGI CGI EFG CDF EFG ABCDEFHI ABCDEF BEFH Actual DVT Symptom Incorrect DVT Symptom Other/None/Not Sure Base: Respondents aware of symptoms at Q4. Q5. Please indicate the signs or symptoms of a blood clot in your leg (also known as deep vein thrombosis). (select all that apply)

  32. Knowledge of Pulmonary Embolism Symptoms Proportion of Adults 18+ which Claim to Know What a PE Would Feel Like BCDEFGHI EFGHI GHI HI Base: All Respondents. Q6. Do you know what a blood clot in your lung (also known as pulmonary embolism) would feel like if you had one personally?

  33. Perceived Symptoms of Pulmonary Embolism Among Adults 18+ Claiming to Know What PE Feels Like COUGH UP BLOOD SHORTNESS OF BREATH LIGHT HEADED / PASS OUT CHEST PAIN RAPID HEART RATE ACTUAL SYMPTOMS OF PE MEAN MEAN MEAN MEAN MEAN 48% 35% 40% 72% 77% BEG G G G G G ADFG DFG DFG DFG G G ACEG CDEFGI DEF DEF DE DE DE ADFGH H H H H Base: Respondents aware of symptoms at Q6. Q7. Please indicate the signs or symptoms of a blood clot in your lung (also known as pulmonary embolism). (select all that apply)

  34. Perceived Symptoms of Pulmonary Embolism Among Adults 18+ Claiming to Know What PE Feels Like SLOW, SHALLOW BREATHING NONE OF THE ABOVE NOT SURE PAIN RADIATING DOWN ARM OTHER FREQUENT HEADACHES INACCURATE SYMPTOMS OF PE MEAN MEAN MEAN MEAN MEAN MEAN 16% 3% 23% 50% 1% 1% ADF AF AF AF ACDFH ACDFH ADFH DF AEFH Base: Respondents aware of symptoms at Q6. Q7. Please indicate the signs or symptoms of a blood clot in your lung (also known as pulmonary embolism). (select all that apply)

  35. Perceived Symptoms of Pulmonary Embolism Among Adults 18+ Claiming to Know What PE Feels Like United Kingdom (D) United States (A) Germany (E) G D G EFG EI EFI CF CEF BCDEF Canada (B) G D EFG EI Argentina (C) Actual PE Symptom GI Incorrect PE Symptom D G Other/None/Not Sure ABEFGI Base: Respondents aware of symptoms at Q6. Q7. Please indicate the signs or symptoms of a blood clot in your lung (also known as pulmonary embolism). (select all that apply)

  36. Perceived Symptoms of Pulmonary Embolism Among Adults 18+ Claiming to Know What PE Feels Like Netherlands (F) Australia (H) Thailand (G) Japan (I) GHI BCGI D EFG EFI CF CDEF CDEFG CEFG EI CEF EF BCDEF DFI Actual PE Symptom Incorrect PE Symptom Other/None/Not Sure Base: Respondents aware of symptoms at Q6. Q7. Please indicate the signs or symptoms of a blood clot in your lung (also known as pulmonary embolism). (select all that apply)

  37. Knowledge of Increased Risk Factors for Blood Clots Among Adults 18+ in Each Country NOT MOVING FOR LONG PERIODS HOSPITAL STAY CANCER SURGERY ACTUAL BLOOD CLOT RISK FACTORS MEAN MEAN MEAN MEAN 36% 16% 63% 25% ACDEFG ACDEFG ACEFG ACEFG AEG ABDEFH AEG DEFH DEFH E E G G ACEG ACEG ACEG ACEG ACEG AEG ABCDEFGH ACDEG ADEG ADEG ADEG EG EG E Base: All Respondents. Q8. Which of the following, if any, could increase your risk of developing a blood clot? (select all that apply)

  38. Knowledge of Increased Risk Factors for Blood Clots Among Adults 18+ in Each Country OLDER AGE (65+) PREGNANCY / RECENT BIRTH FAMILY HISTORY OF BLOOD CLOTS USING ESTROGEN-BASED MEDS ACTUAL BLOOD CLOT RISK FACTORS MEAN MEAN MEAN MEAN 47% 24% 23% 53% ACDEFGH ACDEFG ADEFG ADEG EG EG EG E ABCDEFG AEG AEG AEG AEG AEG EG EFGH EFG EFGH EF ABEG ABEG ABEG AEG AEG EG E E Base: All Respondents. Q8. Which of the following, if any, could increase your risk of developing a blood clot? (select all that apply)

  39. Knowledge of Increased Risk Factors for Blood Clots Among Adults 18+ in Each Country NOT SURE* TOO MUCH EXERCISE HIGH BLOOD PRESSURE DONATING BLOOD HIGH BLOOD CHOLESTEROL INCORRECT BLOOD CLOT RISK FACTORS MEAN MEAN MEAN MEAN MEAN 4% 45% 5% 52% 12% BCDFGHI BFHI FH FH ABCDFGHI BDFH BDF F F F BCDFHI BCDFHI BCDFHI BDHI DH D D D BH H BH *None of these and Other is less than 2% for each country and is therefore not shown on graphs. E BEFGH Base: All Respondents. Q8. Which of the following, if any, could increase your risk of developing a blood clot? (select all that apply)

  40. Knowledge of Increased Risk Factors for Blood Clots Among Adults 18+ in Each Country United States (A) United Kingdom (D) Canada (B) Argentina (C) Germany (E) BCEFGI BCEFGI BCDEFGHI CEGI DEFI BCGI BCEFGHI BCGI CGI CGHI CGI BCDEFGI CEFGI FGI F F E E DFGHI CGI CEGI BCEFGI DEFI GI CGI CGI BCGI CGI CGI CEGI CGHI FI GI F DE DF DH Actual Blood Clot Risk Factors G GI Incorrect Blood Clot Risk Factors I Not Sure* GI I GI *None of these and Other is less than 2% for each country and is therefore not shown on graphs. DFGI DEFH ABDEFH I Base: All Respondents. Q8. Which of the following, if any, could increase your risk of developing a blood clot? (select all that apply) ABDEFGH D

  41. Knowledge of Increased Risk Factors for Blood Clots Among Adults 18+ in Each Country Netherlands (F) BCFGI CGI BCEGI CEGI I BCGI BCGI CGI CGI GI CGHI BCEFGI GI DFGI Australia (H) E ADEH Thailand (G) Japan (I) G I CDEFHI I ABCDEFGH I ABDEFH EFH ABDEFH ADFH DF D Actual Blood Clot Risk Factor Incorrect Blood Clot Risk Factor Not Sure* Base: All Respondents. Q8. Which of the following, if any, could increase your risk of developing a blood clot? (select all that apply) *None of these and Other is less than 2% for each country and is therefore not shown on graphs.

  42. Blood Clot Fact Statements Proportion of Adults 18+ that Agree/Disagree with Each Blood Clot Fact “People under 40 years old have to worry about blood clots.” * Agree Disagree CGI F CGI Neutral G ADH ADEFI CGI CGI “It is likely that a blood clot in the leg left untreated can travel to your lungs.” * CGI ADH ABCDEFH ABDEFHI BCDEFGHI CGI DEFI I CFGI G ABCDEFH ADEI G ABDH CFGI AB “Most blood clots can be prevented.” * CFGI ABH F I G ABDEH I F DI ABCDEFH ABCDEFHI F ADEHI CFGI A AEI FG I G ABCDEH I F C *Compared to what was asked in actual survey, statements have been changed to the positive/affirmative and scales have been reversed. This change has been made for increased ease of interpretation of results. ABCDEGHI ABCDEHI F ABDEHI FG I ABCDEFGH 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5 Base: All Respondents. Q9. When it comes to blood clots, how much do you agree or disagree with each of the following statements?

  43. Blood Clot Fact Statements Proportion of Adults 18+ that Agree/Disagree with Each Blood Clot Fact “Having a blood clot is considered a medical emergency.” * CEFGI CEFGI F Agree GI A ABDEFHI Disagree CEFGI A Neutral GI ABCDH GI ABCDH ABCDEH ABCDEFHI CEFGI A ABCDEFGH “Blood clots can cause death.” BCDEFGHI CGI AF AB ABDEFGH CGI A *Compared to what was asked in actual survey, statements have been changed to the positive/affirmative and scales have been reversed. This change has been made for increased ease of interpretation of results. CGI A AF A CGI ABCDEFH CGI A 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5 ABDEFH ADF Base: All Respondents. Q9. When it comes to blood clots, how much do you agree or disagree with each of the following statements?

  44. Appendix: Individual Country Findings • Analytics Note: • The report findings are weighted to population sizes based on the most recent census data for each country. Statistical testing is at the 95% confidence interval. Aided Awareness indicates respondents were shown a list of terms from which to select their response.

  45. United States Results

  46. United States Summary of Results Awareness of Medical Conditions Lowest among Countries Personal Concern for Medical Conditions Among those Aware of Condition Perceived Blood Clot Risk Factors Blood Clot Fact Statements All circled are Highest among Countries Highest among Countries Risk Factors Non-Risk Factors Highest among Countries Highest among Countries *Compared to what was asked in actual survey, statements have been changed to the positive/affirmative and scales have been reversed. This change has been made for increased ease of interpretation of results. Agree Neutral Disagree

  47. United States Summary of Results Highest among Countries Perceived PE Symptoms Claimed Knowledge of What a PE Would Feel Like Highest among Countries Symptoms Non- Symptoms Perceived DVT Symptoms Perceived Cause of DVT Symptoms Highest among Countries Non- Symptoms Claimed Knowledge of What a DVT Would Feel Like

  48. United States Summary of Results Older Americans (> 39 years old) display greater awareness of specific medical conditions. • Awareness of the medical condition terms, in general, is highest among Americans over the age of 39. • Interestingly, the only exception is for pulmonary embolism where younger females were more aware (70%) than middle-aged males (66%). This is likely due to the connection with hormone therapies. Awareness of the term “thrombosis” is lowest among countries surveyed, however the U.S. is among the top three countries for “deep vein thrombosis” and “pulmonary embolism” awareness. • Although awareness for thrombosis (52%), deep vein thrombosis (57%), and pulmonary embolism (70%) is lower than the other medical terms measured, the same trends arise – awareness is generally higher among older Americans as well as females. • Among the three terms, pulmonary embolism is the most commonly recognized among Americans. • Americans living in rural areas are directionally more aware of all three terms. Younger American males are more concerned with general medical conditions compared to the other demographics. • Although young men are generally less aware of the medical terms measured, among those aware of the terms, young men are more concerned about the conditions as compared to other demographics. • The only exception is for the term pulmonary embolism where younger females are more aware (70%) than middle-aged males (66%). Again, this is likely due to the connection with hormone therapies. Approximately one-in-five Americans aware of thrombosis, DVT, and PE are personally concerned about the conditions. • Though older Americans are more at risk for thrombosis conditions, the demographic is no more concerned than younger Americans.

  49. United States Summary of Results Just over half of American adults (55%) are aware that a blood clot in a vein is the cause of a deep vein thrombosis. • Older females are more knowledgeable about the cause of a deep vein thrombosis compared to younger demographics. Claimed knowledge of what a DVT would feel like is similar among all American demographics. • Swelling of the leg (81% ) and the leg feeling warm to the touch (58%) are the most polarizing DVT symptoms in terms of awareness. A larger proportion of young American men claim to know what a PE would feel like compared to other demographics, however this group is not as knowledgeable about PE symptoms. • Older females (65+) appear to be the most educated in terms of PE symptoms with a large proportion selected the correct symptoms and small proportion selecting the incorrect symptoms. The most commonly known risk factors for blood clots include not moving for long periods, a family history of blood clots, and recent surgery. • Americans are also generally knowledgeable that too much exercise or giving blood are not risk factors; however, high cholesterol and high blood pressure are often considered risk factors when in fact they are not. • In general, women over 40 are the most knowledgeable about risk factors for blood clots. Although Americans in general correctly agreed or disagreed in accordance with the blood clot fact statements, younger Americans more often answered incorrectly. • Younger Americans are more likely to think people under 40 do not need to worry about blood clots, most blood clots cannot be prevented, an untreated blood clot in your leg cannot travel to your lung, and having a blood clot is not considered a medical emergency. • Americans living in urban areas followed the same pattern as younger Americans, most likely because significantly more 18-39 year olds claimed to live in larger cities compared to the other two age demographics.

  50. Aided Awareness of Various Medical Conditions Prostate Cancer Breast Cancer Stroke AIDS High Blood Pressure Heart Attack Hemo-Distension Syndrome* Ages Ages Ages Ages Ages Ages Ages 18-39 18-39 18-39 18-39 18-39 18-39 18-39 40-64 40-64 40-64 40-64 40-64 40-64 40-64 A A A A A A A B B B B B B B 65+ 65+ 65+ 65+ 65+ 65+ 65+ C C C C C C C D D D D D D D Blue bars Represent Males E E E E E E E F F F F F F F Red bars Represent Females *Fictitious disease for reference of over-agreeance Base: All U.S. Respondents. Males: 18-39 (n=64), 40-64 (n=148), 65+ (n=161); Females: 18-39 (n=96), 40-64 (n=172), 65+ (n=160) Q1. For each medical condition or term listed, indicate if you are aware of or have ever heard the term.

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