Pharmacists' Intervention in Inappropriate Aspirin Prescribing in a Geriatric Primary Care Clinic

Area of Science:

• Geriatric Medicine
• Cardiovascular Disease Prevention
• Pharmacist Intervention

Background:

• Aspirin's role in primary prevention of atherosclerotic cardiovascular disease (ASCVD) is controversial due to lack of improved outcomes and increased bleeding risk.
• Despite evidence, many older adults continue aspirin for primary prevention, highlighting a gap in guideline adherence.
• Identifying and addressing inappropriate aspirin prescriptions is crucial for patient safety in geriatric populations.

Purpose of the Study:

• To evaluate the impact of pharmacist-led interventions on discontinuing inappropriate aspirin prescriptions for primary prevention.
• To assess the effectiveness of pharmacist recommendations in a geriatric primary care setting.

Main Methods:

• Retrospective review of patients prescribed aspirin in a geriatric primary care clinic.
• Pharmacists identified aspirin indications, recommending discontinuation for primary prevention cases.
• Documented acceptance and decline rates of pharmacist recommendations.

Main Results:

• Out of 528 patients, 122 (48%) were taking aspirin for primary prevention.
• Pharmacists recommended discontinuation for 122 patients, with 91 recommendations accepted (75% acceptance rate).
• A significant proportion of patients were inappropriately prescribed aspirin for primary ASCVD prevention.

Conclusions:

• Pharmacist review is effective in identifying and discontinuing inappropriately prescribed aspirin for primary ASCVD prevention in older adults.
• Routine assessment of aspirin appropriateness is necessary to align medication use with current evidence and guidelines.
• This intervention demonstrates the value of pharmacists in optimizing medication management and improving patient outcomes in geriatric care.