Arch Dis Child doi:10.1136/adc.2011.300085
  • Review

HEEADSSS assessment for adolescents requiring anticoagulation therapy

  1. Fiona Newall1,2,3,4
  1. 1Department of Paediatrics, The University of Melbourne, Melbourne, Australia
  2. 2Department of Nursing, The University of Melbourne, Melbourne, Australia
  3. 3Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
  4. 4Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia
  1. Correspondence to Sophie Jones, Department of Clinical Haematology, The Royal Children's Hospital, 4th Floor East Building, Flemington Road, Parkville, VIC 3052, Australia; sophie.jones{at}
  • Received 22 March 2011
  • Accepted 26 October 2011
  • Published Online First 5 December 2011


The care of adolescents with complex chronic illness needs to be developmentally appropriate to encourage adherence, knowledge retention and self-management. There has been an increase in the number of adolescents requiring long-term or lifelong anticoagulation therapy, related to either an underlying illness or idiopathic deep vein thrombosis. The burden of anticoagulant therapy, the associated risks and the required lifestyle changes can significantly impact on psychosocial well-being in the adolescent patient. This review identifies issues pertinent to adolescent anticoagulation management and discusses strategies to support optimal management. The HEEADSSS (Home, Education and employment, Eating, Activities with peers, Drugs, Sexual activity, Suicide and depression, and Safety) framework was used to provide guidance in undertaking a psychosocial assessment of adolescents requiring anticoagulant therapy in conjunction with a structured education strategy. Adolescent anticoagulant management strategies employing developmentally appropriate assessment and education will likely result in improved therapeutic outcomes for the patient and potentially facilitate transition to adult-based care.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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