Implementation of an Aspirin Utilization Program in an Early Pregnancy Access Center

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Low-dose aspirin (LDA) is recommended for preeclampsia prevention but is underutilized.
• Standardized screening, patient education, and healthcare system contact can improve LDA uptake.

Purpose of the Study:

• To evaluate a multifaceted intervention's effectiveness in increasing LDA initiation for preeclampsia prevention at the recommended gestational age.
• To compare LDA utilization rates between an intervention group and a routine prenatal care group.

Main Methods:

• Observational cohort study at a large urban medical center.
• Intervention included standardized screening, aspirin prescribing with education, and follow-up outreach.
• Primary outcome: proportion of eligible patients initiating aspirin by 16 weeks gestation.

Main Results:

• The intervention group showed significantly higher LDA initiation by 16 weeks (70.7% vs. 38.6%) and continuation at 24 weeks (74.7% vs. 43.8%).
• Both groups had high prevalence of hypertensive disorders of pregnancy (HDP).
• Patients in both cohorts were predominantly Black or Hispanic with public insurance.

Conclusions:

• A standardized, multifaceted approach to identify, educate, and support at-risk patients increases LDA utilization for preeclampsia prevention.
• Obstetric providers can implement similar strategies to bridge the quality gap in LDA use.