Aspirin usage in a large teaching hospital diabetes clinic setting

To document aspirin usage and the prevalence of large and small vessel complications in patients with diabetes mellitus (DM) attending the outpatient diabetes clinics of a large public hospital.

All patients attending diabetes outpatient clinics at The Royal Melbourne Hospital in Melbourne, Australia were surveyed over a 3-month period.

Complete data were available on 629 of 632 (296 male) patients surveyed. Of the 29.3% of patients who were suffering from one or more macrovascular complication (ischaemic heart disease, cerebrovascular disease or peripheral vascular disease), 63% were currently on aspirin treatment. Of those not on aspirin, 65% had no contra-indication to aspirin treatment and a further 19% had only a relative contra-indication of either aspirin or warfarin treatment recorded.

The published recommendations for the use of aspirin in patients with macrovascular disease were generally being followed in this clinic-based population. However, a significant proportion of patients without a contra-indication to treatment were still not receiving aspirin. The lack of clear evidence-based guidelines for aspirin use may be a factor in its under-prescription. This survey suggests clear evidence-based guidelines should be established and disseminated.