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Does professional advice influence aspirin use to prevent heart disease in an HMO population?
P J O'Connor1, N P Pronk, A W Tan
1Health Partners Research Foundation, St. Paul, MN, USA.
Insights
Aspirin is frequently used by health maintenance organization (HMO) members, especially those with coronary artery disease. Professional advice significantly influences patient decisions regarding aspirin use for heart disease prevention.
Area of Science:
- Cardiology
- Preventive Medicine
- Health Services Research
Background:
- Aspirin is recognized for its potential to reduce coronary artery disease (CAD) events in specific patient populations.
- Understanding factors influencing aspirin use is crucial for optimizing preventive cardiovascular strategies within managed care settings.
Purpose of the Study:
- To examine the factors associated with aspirin use for heart disease prevention among members of a large Health Maintenance Organization (HMO).
Main Methods:
- A population-based survey was conducted among 8000 Health Maintenance Organization (HMO) members aged 40 and older in the midwestern United States.
- The survey assessed aspirin usage, physician recommendations for aspirin, and cardiovascular risk factors. Participants were stratified based on the presence of chronic conditions like diabetes, hypertension, lipid disorders, or heart disease.
- A mailed survey achieved a corrected response rate of 82.4%.
Main Results:
- Overall, 38% of respondents reported using aspirin at least three times weekly for heart disease prevention.
- Aspirin use was significantly higher in patients with diagnosed coronary artery disease (71.3%) compared to those without (27.7%) (P < 0.001).
- Professional advice to use aspirin was a strong predictor of self-reported use (odds ratio, 13.86; P < 0.001), even after adjusting for demographic and clinical factors.
Conclusions:
- Aspirin is widely utilized by Health Maintenance Organization (HMO) members diagnosed with coronary artery disease to prevent future cardiovascular events.
- Physician recommendations appear to be a key determinant of aspirin adherence in this population.
Objective:
Aspirin use seems to reduce coronary artery disease events in some groups of patients. Factors associated with use of aspirin to prevent heart disease in an HMO population were examined.
Design:
A population-based survey.
Setting:
A large HMO in the midwestern United States.
Participants:
8000 health plan members 40 years of age and older.
Main Outcome Measures:
The survey assessed use of aspirin, professional advice to use aspirin, and coronary heart disease risk factors and status. The sample was stratified by whether members had none, one, or more than one of the following chronic conditions: diabetes, hypertension, lipid disorder, or heart disease. The mailed survey had a corrected response rate of 82.4%.
Results:
Overall, 38% of respondents reported using aspirin at least three times a week to prevent heart disease. Aspirin use did not vary in owned versus contracted clinics. Aspirin use was 71.3% in patients with and 27.7% in patients without diagnosed coronary heart disease (P < 0.001). In logistic regression models, professional advice to take aspirin was strongly associated with self-reported use of aspirin (odds ratio, 13.86) (P < 0.001) after adjustment for age, sex, level of education, and chronic disease status.
Conclusions:
Aspirin is widely used by HMO members with coronary artery disease to prevent subsequent coronary artery disease events. Professional advice to use aspirin seems to be strongly related to aspirin use.