Improving aspirin prophylaxis in a primary care diabetic population.
OBJECTIVE
To evaluate and improve adherence to American Diabetes Association guidelines for prophylactic aspirin therapy in ambulatory patients with diabetes using a pharmacy-directed intervention.


METHODS
Unblinded, single intervention.


METHODS
Rural, primary care clinic.


METHODS
Eighty-five patients with a diagnosis of diabetes mellitus.


METHODS
Patients with diabetes were identified from database searches and routine clinic visits. Medical records were screened for aspirin use, allergies, adverse events, and contraindications. During routine clinic visits or structured telephone interviews, patients with indications for aspirin therapy were advised to begin enteric-coated aspirin 81 mg/day A follow-up survey assessed adherence.


RESULTS
At baseline, 28 (33%) of 85 patients were receiving aspirin therapy An additional 8 patients had contraindications to aspirin, and 2 patients had no indications for aspirin therapy Aspirin was recommended to 27 patients during clinic interventions and to 15 patients during telephone interventions. Two patients declined the recommendation. At the completion of this intervention, 70 (82%) of 85 patients were receiving daily aspirin or had accepted the recommendation to begin therapy.


CONCLUSIONS
A pharmacy-directed intervention increased prophylactic aspirin therapy in patients with diabetes from 33% of patients at baseline to 82% at the end of the study The intervention, which has a simple, patient-focused design, serves as a template for improving aspirin prophylaxis among patients with diabetes in other ambulatory settings.
Faragon
John J
JJ
Department of Pharmacy Practice, Albany College of Pharmacy, Albany, New York 12208, USA. faragonj@acp.edu
Waite
Nancy M
NM
Hobson
Eric H
EH
Seoldo
Nathalie
N
VanAmburgh
Jenny A
JA
Migden
Hedy
H
D001241:Aspirin / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003625:Data Collection; D048909:Diabetes Complications; D004363:Drug Utilization / Q000639:trends; D006801:Humans; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011320:Primary Health Care
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin