Aspirin Is Often Misused in Preventing CVD in Patients With Diabetes
Aspirin is often overused for the prevention of cardiovascular (CV) disease in patients with diabetes but is underused in patients with reversible CV risk factors who do not have diabetes, according to new research.
The results of the study were presented at the European Association for the Study of Diabetes 2016 Annual Meeting on September 13, 2016.
Could Aspirin Slow Progression of Emphysema?
USPSTF Releases New Aspirin Recommendations
o conduct their randomized trial, the investigators examined the impact of new software on the appropriateness of aspirin prescribing for about 3958 people with diabetes but no CV disease and 7000 with reversible CV risk factors but no diabetes and were treated at 20 primary care clinics in 2013 and 2014.
The clinics were randomly assigned to usual care (n=10) or to the use of a decision-support tool (n=10). The tool identified people with CV risk and targeted poorly controlled reversible risk factors (ie, hypertension, dyslipidemia, tobacco use).
About 71% of patients with diabetes were taking aspirin at baseline. Of those who were not indicated to take aspirin (n=1474), 57% were taking it—suggesting an overuse. Only 79% of the 2484 patients with diabetes who should have been taking aspirin were actually taking it—suggesting an underuse.
Among patients without diabetes but with reversible risk factors, 27% were taking aspirin. Of those, 34% of the 1659 patients who were not indicated to take aspirin were taking it, but only 25% of the 5341 patients who should have been taking aspirin were taking it.
In addition, after implementing the decision-support tool, aspirin use increased significantly from 10% to 13% among patients with reversible risk factors for whom aspirin was indicated.
Crain AL, Speri-Hillen JM, O’Connor PJ, Desai JR, Margolic KL, Ekstrom HL. Overuse and underuse of acetyl-salicylic acid for primary prevention of cardiovascular disease in people with diabetes. Paper presented at: European Association for the Study of Diabetes (EASD) 2016 Annual Meeting; September 12-16, 2016; Munich, Germany. http://www.easdvirtualmeeting.org/resources/overuse-and-underuse-of-acetyl-salicylic-acid-for-primary-prevention-of-cardiovascular-disease-in-people-with-diabetes. Accessed September 15, 2016.