Improving aspirin prophylaxis in a primary care diabetic population

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Adherence to American Diabetes Association guidelines for prophylactic aspirin therapy in diabetic patients is suboptimal.
• Cardiovascular disease remains a leading cause of morbidity and mortality in patients with diabetes mellitus.

Purpose of the Study:

• To evaluate and enhance adherence to American Diabetes Association guidelines for prophylactic aspirin therapy in ambulatory patients with diabetes.
• To implement and assess a pharmacy-directed intervention aimed at improving aspirin use.

Main Methods:

• An unblinded, single intervention study was conducted in a rural primary care clinic.
• Eighty-five patients with diabetes mellitus were identified, and their records were screened for aspirin use and contraindications.
• A pharmacy-directed intervention involved advising patients with indications to start 81 mg enteric-coated aspirin daily, with follow-up assessments.

Main Results:

• Baseline aspirin use was 33% (28/85 patients).
• Following the intervention, 82% (70/85 patients) were either on aspirin therapy or had accepted the recommendation.
• Contraindications were noted in 8 patients, and 2 had no indications for aspirin therapy.

Conclusions:

• A pharmacy-directed intervention effectively increased prophylactic aspirin therapy in patients with diabetes.
• The intervention demonstrated a significant improvement in aspirin prophylaxis, from 33% to 82%.
• This patient-focused intervention can serve as a model for other ambulatory settings to improve aspirin use in diabetic populations.