scholarly journals Prevalence of Aspirin Prescriptions among Type 2 Diabetic Patients in Songklanagarind Hospital

2018 ◽  
Vol 36 (1) ◽  
pp. 35
Author(s):  
Rattanaporn Chootong ◽  
Silom Jamulitrat
Keyword(s):  
Cardiovascular Disease ◽  
Side Effects ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Aspirin Therapy ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
History Of ◽  
Prevention Of Cardiovascular Disease

Objective: The American Diabetes Association (ADA) and the American Heart Association (AHA) recommend aspirin use for primary and secondary prevention of cardiovascular disease in patients with diabetes. There are, however, some doubts regarding the prescription of aspirin therapy to prevent cardiovascular events in diabetic patients, aspects of its safety, and contraindications of the drug administration. This study was conducted in order to evaluate the amount of prescribed aspirin for diabetic patients who received the treatment at Songklanagarind Hospital.Material and Method: A cross-sectional study was conducted to review the medical records of diabetic patients who received the treatment at outpatient departments from 1st-31st December 2013.Results: A total of 1,342 diabetic patients are included in this study: 80.3% from the primary prevention group and 19.7% from the secondary prevention group. Mean age was 64.3 years old. Of the patients, 44.7% were male. The study revealed that prescribed aspirin accounted for one-third of total prescriptions (31.7%). The primary prevention group was 19.0% (95% confidence interval (CI)=12.0-21.3) and the secondary prevention group was 83.7% (95% CI=78.6-87.9). The departments that frequently prescribed aspirin for the primary prevention group was endocrinology (21.2%) and for the secondary prevention group it was the Primary Care Unit (87.5%). Aspirin side effects were gastrointestinal 1.0% and tinnitus 0.1%. Aspirin contraindications were active peptic ulcer (0.1%), history of gastrointestinal bleeding (0.4%), bleeding disorders (0.2%), history of recent intracranial bleeding (0.2%) and severe liver disease (0.9%). There was a positive correlation between age, hemoglobin A1c (HbA1c) and the dose of prescribed aspirin (p-value<0.001, 0.003 respectively). These patients were more likely to have the dose of aspirin increased as age and HbA1c increased.Conclusion: Despite aspirin being a safe, inexpensive and readily available therapy that is effective in preventing cardiovascular disease in diabetic patients and likely to provide benefits rather than side effects and contraindications. The author found significant underuse of aspirin therapy, especially in the primary prevention of cardiovascular disease in diabetic patients. 

scholarly journals Prevalence of Under-Prescription in Elderly Type 2 Diabetic Patients in the Primary Care Unit of a University Hospital

2018 ◽  
Vol 36 (4) ◽  
Author(s):  
Thareerat Ananchaisarp ◽  
Namfon Duangkamsee ◽  
Bongkot Burapakiat ◽  
Theerapat Buppodom ◽  
Ukrit Rojanusorn ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Primary Prevention ◽  
University Hospital ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Primary Care Unit ◽  
Type 2 Diabetic ◽  
Prevention Of Cardiovascular Disease

Objectives: This study aimed to assess the prevalence of under-prescription among elderly type 2 diabetic patients in the primary care unit of a university hospital in southern Thailand and identify the associated factors.Material and Methods: A 1-year retrospective medical record review was conducted in elderly type 2 diabetic patients treated continuously in the primary care unit. Under-prescription was the primary outcome assessed from criteria developed from the START criteria (2015), Thailand’s clinical practice guideline for diabetes (2014), and for hypertension (2015).Results: This study included 458 medical records that fit our inclusion criteria. The median age was 69.1 years old and more than 80% of them had a comorbidity of dyslipidemia or hypertension. The prevalence of under-prescription in elderly type 2 diabetic patients was 84.5%. The most commonly omitted medication was aspirin for primary prevention of cardiovascular disease. An increased number of medications received and having cardiovascular disease was associated with a lower risk of under-prescription.Conclusion: The prevalence of the omission of beneficial medications in elderly type 2 diabetic patients in the primary care unit of a university hospital was high, especially under-prescription of aspirin for primary prevention of cardiovascular disease.

scholarly journals Appropriateness of aspirin prescribing for primary and secondary prevention of cardiovascular disease in type 2 diabetes in different care settings

2021 ◽  
Author(s):  
Shi Ying Tan ◽  
Heather Cronin ◽  
Stephen Byrne ◽  
Adrian O’Donovan ◽  
Antoinette Tuthill
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Shared Care ◽  
University Hospital ◽  
Cross Sectional ◽  
Prevention Of Cardiovascular Disease

Abstract Background Type 2 diabetes is associated with an increased cardiovascular risk. Use of aspirin has been shown to be of benefit for secondary prevention of cardiovascular disease in patients with type 2 diabetes; benefits in primary prevention have not been clearly proven. Aims This study aims to (a) determine if aspirin is prescribed appropriately in type 2 diabetes for primary or secondary prevention of cardiovascular disease (CVD) and (b) evaluate whether there are differences in aspirin prescribing according to where people receive their care. Design Cross-sectional study Methods The medical records of individuals with type 2 diabetes aged over 18 years and attending Elmwood Primary Care Centre and Cork University Hospital Diabetes outpatient clinics (n = 400) between February and August 2017 were reviewed. Results There were 90 individuals exclusively attending primary care and 310 persons attending shared care. Overall, 49.0% (n = 196) of those were prescribed aspirin, of whom 42.3% were using it for secondary prevention. Aspirin was used significantly more in people attending shared care (p < 0.001). About 10.8% of individuals with diabetes and CVD attending shared care met guidelines for, but were not prescribed aspirin. Conclusion A significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. In contrast, a substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention.

Aspirin Dose for Prevention of Cardiovascular Disease in Diabetics

2003 ◽  
Vol 37 (1) ◽  
pp. 116-121 ◽  
Author(s):  
Sandra N Nowak ◽  
Linda A Jaber
Keyword(s):  
Cardiovascular Disease ◽  
Aspirin Therapy ◽  
Biomedical Literature ◽  
Diabetic Patients ◽  
Vascular Events ◽  
Cardiovascular Protection ◽  
Patients With Diabetes ◽  
Relationship Of ◽  
Key Terms ◽  
Prevention Of Cardiovascular Disease

OBJECTIVE To determine whether a specific dose of aspirin can be recommended for prevention of cardiovascular disease in patients with diabetes. DATA SOURCE Biomedical literature was accessed through MEDLINE (1990–February 2002). Key terms included diabetes, cardiovascular protection, and aspirin. DATA SYNTHESIS Pharmacologic and clinical studies focusing on the dose–response relationship of aspirin therapy were reviewed. Evidence supports the benefit of low-dose aspirin therapy in reducing vascular events in secondary and primary prevention trials in various patient populations; however, some studies suggest larger doses of aspirin may be needed in certain patients. CONCLUSIONS Review of the evidence does not support a particular dose of aspirin for cardiovascular protection in diabetic patients. Clinical guidelines recommend aspirin therapy in the range of 81–325 mg/d. However, due to an increased prevalence of cardiovascular morbidity and disturbances in coagulation in diabetic patients, the dose of aspirin for prevention of cardiovascular disease in these individuals may be different from that in other populations and requires further evaluation.

Rates and Predictors of Physician-Recommended and Self-Reported Aspirin Use in 2015

2020 ◽  
Vol 35 (12) ◽  
pp. 556-565
Author(s):  
Taylor Naberhaus ◽  
Nicole K. Early ◽  
Kathleen A. Fairman ◽  
Kelsey Buckley
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Task Force ◽  
Community Dwelling ◽  
Behavioral Risk ◽  
Medication History ◽  
Cross Sectional ◽  
Study Results ◽  
History Of

OBJECTIVE: This study assesses the rate of providerrecommended aspirin use through the National Ambulatory Medical Care Survey (NAMCS) database versus self-reported aspirin use through the Behavioral Risk Factor Surveillance System (BRFSS) database and identifies factors that predict initiation of aspirin. This study provides insight into the rate of providerrecommended aspirin use versus self-reported aspirin use prior to the 2016 United States Preventive Service Task Force primary prevention recommendation update.<br/> DESIGN: Retrospective, cross-sectional analysis of US population data obtained from medical records (NAMCS) and community-dwelling residents in four states (BRFSS) in 2015.<br/> SETTING: Physician offices (NAMCS) and households or telephone (BRFSS).<br/> PATIENTS, PARTICIPANTS: NAMCS: visits made by patients 40 years of age or older to physicians who permitted federal employees to abstract officevisit data. BRFSS: household or telephone interview respondents 40 years of age or older.<br/> INTERVENTIONS: Comparisons of persons with (secondary prevention) versus without (primary prevention) cardiovascular disease.<br/> MAIN OUTCOME MEASURED: Recommended (NAMCS) or self-reported (BRFSS) use of aspirin.<br/> RESULTS: The sample included 19 170 patients (NAMCS), with 2 205 having a history of cardiovascular disease and 14 872 respondents (BRFSS) with 2 024 having a history of cardiovascular disease. For both primary and secondary prevention, respondents from BRFSS reported higher rates of aspirin use (27.7% primary, 65.6% secondary prevention) compared with prescribed rates from NAMCS (11.7% primary, 45.6% secondary prevention).<br/> CONCLUSIONS: Study results highlight the value of obtaining a complete medication history, including aspirin use, from all patients.

scholarly journals Cross-sectional analysis of the prevalence and predictors of statin utilisation in Ireland with a focus on primary prevention of cardiovascular disease

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018524 ◽  
Author(s):  
Paula Byrne ◽  
John Cullinan ◽  
Catríona Murphy ◽  
Susan M Smith
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Sociodemographic Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Base Category ◽  
Sectional Analysis ◽  
Prevention Of Cardiovascular Disease

ObjectiveTo describe the prevalence of statin utilisation by people aged over 50 years in Ireland and the factors associated with the likelihood of using a statin, focusing particularly on those using statins for primary prevention of cardiovascular disease (CVD).MethodsThis is a cross-sectional analysis of cardiovascular risk and sociodemographic factors associated with statin utilisation from wave 1 of The Irish Longitudinal Study on Ageing. A hierarchy of indications for statin utilisation, consisting of eight mutually exclusive levels of CVD-related diagnoses, was created. Participants were assigned one level of indication. The prevalence of statin utilisation was calculated. The likelihood that an individual was using a statin was estimated using a multivariable logistic regression model, controlling for cardiovascular risk and sociodemographic factors.ResultsIn this nationally representative sample (n=5618) of community-dwelling participants aged 50 years and over, 1715 (30.5%) were taking statins. Of these, 65.0% (57.3% of men and 72.7% of women) were doing so for the primary prevention of CVD. Thus, almost two-thirds of those taking statins did so for primary prevention and there was a notable difference between women and men in this regard. We also found that statin utilisation was highest among those with a prior history of CVD and was significantly associated with age (compared with the base category 50–64 years; 65–74 years OR 1.38 (95% CI 1.16 to 1.65); 75+ OR 1.33 (95% CI 1.04 to 1.69)), living with a spouse or partner (compared with the base category living alone; OR 1.35 (95% CI 1.10 to 1.65)), polypharmacy (OR 1.74 (95% CI 1.39 to 2.19)) and frequency of general practitioner visits (compared with the base category 0 visits per year; 1–2 visits OR 2.46 (95% CI 1.80 to 3.35); 3–4 visits OR 3.24 (95% CI 2.34 to 4.47); 5–6 visits OR 2.98 (95% CI 2.08 to 4.26); 7+ visits OR 2.51 (95% CI 1.73 to 3.63)), even after controlling for clinical need. There was no association between using statins and gender, education, income, social class, health insurance status, location or Systematic Coronary Risk Evaluation (SCORE) risk in the multivariable analysis.ConclusionStatin utilisation among those with no history of CVD accounted for almost two-thirds of all statin use, in part reflecting the high proportion of the population with no history of CVD, although utilisation rates were highest among those with a history of CVD.

scholarly journals Cardiovascular outcomes trials with statins in diabetes

2018 ◽  
Vol 18 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Fariha Naeem ◽  
Gerard McKay ◽  
Miles Fisher
Keyword(s):  
Cardiovascular Disease ◽  
Side Effects ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Statin Therapy ◽  
Cardiovascular Events ◽  
Atherosclerotic Disease ◽  
Lipid Lowering ◽  
High Dose ◽  
Drug Side Effects

Treatment with statins is one of the most effective ways of reducing cardiovascular events in those with diabetes. Many studies containing thousands of subjects with diabetes have demonstrated that statins reduce cardiovascular events when there is no known cardiovascular disease (primary prevention) and in those with confirmed atherosclerotic disease (secondary prevention). High-dose statins appear to be even more effective in established cardiovascular disease, but at the expense of increased drug side effects. In this paper we review the evidence for the benefits of statins in diabetes. In a second review we will examine the evidence for possible benefits of other lipid-lowering therapies when these are added to background statin therapy in diabetes.

Use of Antiplatelet Agents for Primary and Secondary Prevention of Cardiovascular Disease Amongst Type 2 Diabetic Patients

2008 ◽  
Vol 21 (4) ◽  
pp. 287-301 ◽  
Author(s):  
Hasniza Zaman Huri ◽  
Lee Qiu Yi ◽  
Rokiah Pendek ◽  
Che Zuraini Sulaiman
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Antiplatelet Therapy ◽  
Antiplatelet Agents ◽  
Prevention Of Cardiovascular Disease

Background. A retrospective observational study was conducted to study the use of antiplatelet agents for primary and secondary prevention of cardiovascular disease among hospitalized type 2 diabetes mellitus patients. Method. A total of 355 patients were included in the study. The compliance with the American Diabetes Association recommendation on the use of antiplatelet therapy for prevention of cardiovascular disease was studied. Results. For the primary prevention group, type 2 diabetes mellitus, patients with known dyslipidemia were more likely to receive antiplatelet therapy than those without dyslipidemia (P = 0.023). The rate of adherence to the American Diabetes Association recommendations on the use of antiplatelet therapy for secondary prevention of cardiovascular disease was higher than for primary prevention of cardiovascular disease (P = 0.001). Conclusion. In conclusion, many of the eligible patients still do not receive antiplatelet therapy, particularly in primary prevention of cardiovascular disease. Measures should be taken to ensure that type 2 diabetes mellitus patients receive the antiplatelet therapy and hence prevent macrovascular complications.

An aspirin a day? Clinical utility of aspirin therapy for the primary prevention of cardiovascular disease

2019 ◽  
Vol 17 (8) ◽  
pp. 561-573 ◽  
Author(s):  
Michael E. Plazak ◽  
Mallory T. Mouradjian ◽  
Kristin Watson ◽  
Brent N. Reed ◽  
Zachary R. Noel ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Clinical Utility ◽  
Aspirin Therapy ◽  
Prevention Of Cardiovascular Disease
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