Compliance with USPSTF recommendations on aspirin for prevention of cardiovascular disease in men.
OBJECTIVE
In 2009, United States Preventive Services Taskforce (USPSTF) recommends aspirin (ASA) for men aged 45-79 years when the benefit of coronary artery disease (CAD) risk reduction outweighs the harm of gastrointestinal haemorrhage. Our objective is to evaluate compliance with this USPSTF recommendation.


METHODS
This study is a cross-sectional study and 2011-2012 National Health and Nutrition Examination Survey (NHANES) dataset was used for this study. Out of the available sample, 1155 (11.8%) had the inclusion criteria (men aged 45-79 years, no prior history of CAD). The participants' 10-year Framingham risk score for developing CAD was calculated to identify the people who meet criteria to take aspirin. The population characteristics that influence the physicians' decision to prescribe aspirin and the characteristics those influence the participants' compliance with doctor's advice to take aspirin were identified.


RESULTS
Almost 91.5% qualified for aspirin intake. About 65% (595/916) of them were not advised by their providers to take aspirin. Among the 321 who were prescribed aspirin, 30% (96/321) were non-compliant and 1.2% (4/321) discontinued aspirin because of side effects. In the group that did not qualify for aspirin, 37.6% (32/85) were inappropriately prescribed aspirin out of which 78.1% (25/32) were actually taking it. Younger age and lesser comorbidities were significantly associated with under prescription by physicians (P < .001) and lower compliance by participants (P < .001).


CONCLUSIONS
In April 2016, USPSTF updated the recommendations regarding benefits of aspirin. Our study evaluates the factors that influenced the compliance with the 2009 recommendations. This study highlights the challenges that the 2016 guidelines might have to face.
Department of Hospital Medicine, Jeanes Hospital, Temple University Health System, Philadelphia, PA, USA.
Srikrishna Varun
SV
Malayala
Department of Infectious Diseases, Cooper University, Camden, NJ, USA.
Ambreen
A
Raza
D000368:Aged; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced; D019983:Guideline Adherence; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009749:Nutrition Surveys; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin