Aspirin Use and Counseling About Aspirin Among Patients With Diabetes
Aspirin Use and Counseling About Aspirin Among Patients With Diabetes Sarah L. Krein , PHD, RN 1 2 3 , Sandeep Vijan , MD, MS 1 2 3 , Leonard M. Pogach , MD, MBA 4 5 , Mary M. Hogan , PHD, RN 1 and Eve A. Kerr , MD, MPH 1 2 1 Department of Veterans Affairs’ Center for Practice Management and Outcome...
Saved in:
| Published in: | Diabetes care Vol. 25; no. 6; pp. 965 - 970 |
|---|---|
| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Alexandria, VA
American Diabetes Association
01-06-2002
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Aspirin Use and Counseling About Aspirin Among Patients With Diabetes
Sarah L. Krein , PHD, RN 1 2 3 ,
Sandeep Vijan , MD, MS 1 2 3 ,
Leonard M. Pogach , MD, MBA 4 5 ,
Mary M. Hogan , PHD, RN 1 and
Eve A. Kerr , MD, MPH 1 2
1 Department of Veterans Affairs’ Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann
Arbor, Michigan
2 Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
3 Michigan Diabetes Research and Training Center, Ann Arbor, Michigan
4 VA New Jersey Healthcare System, East Orange, New Jersey
5 University of Medicine and Dentistry of New Jersey, Newark, New Jersey
Abstract
OBJECTIVE —Despite being a safe, effective therapy for lowering cardiovascular risk, only 20% of diabetic patients were using aspirin
in the early 1990s. This study examines current physician practices and the use of aspirin therapy by individuals with diabetes.
RESEARCH DESIGN AND METHODS —A random sample of diabetic patients receiving care in the Department of Veterans Affairs health care system were surveyed
during January-March 2000. The association between aspirin counseling, aspirin use, and reported coronary vascular disease
(CVD) and classical CVD risk factors were examined using logistic regression. The effect of increasing aspirin use on risk
of myocardial infarction (MI) and cardiovascular mortality was demonstrated by simulation.
RESULTS —Seventy-one percent of respondents reported being counseled about aspirin use, and 66% were taking daily aspirin. Individuals
with known CVD were more likely to be counseled (odds ratio [OR] 4.9, 95% CI 2.9–8.1) and to use aspirin (2.1, 1.2–3.7). The
factor most strongly associated with aspirin use was having been counseled about aspirin therapy by a doctor. We estimate
that for this population, increasing daily aspirin use to 90% could prevent an additional 11,000 MIs and potentially save
>8,000 lives.
CONCLUSIONS —Compared with previous reports, a substantial proportion of these diabetic patients have been counseled about and use aspirin.
Most clinicians recognize aspirin as an important treatment for patients with preexisting coronary disease. However, since
diabetes is now considered a CVD equivalent, it is imperative that clinicians include counseling about aspirin therapy as
a care priority for all their diabetic patients, as this simple intervention may prevent many cardiovascular events and deaths.
CVD, coronary vascular disease
DQIP, Diabetes Quality Improvement Project
MI, myocardial infarction
OR, odds ratio
VA, Veterans Affairs
VISN, veterans integrated service network
Footnotes
Address correspondence and reprint requests to Sarah L. Krein, Ann Arbor VA HSR&D, P.O. Box 130170, Ann Arbor, MI 48113. Hand-delivered
mail must be sent to 24 Frank Lloyd Wright Dr., 3rd floor, Lobby L, Ann Arbor, MI 48106. E-mail: skrein{at}umich.edu .
Received for publication 14 November 2001 and accepted in revised form 21 February 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
DIABETES CARE |
|---|---|
| ISSN: | 0149-5992 1935-5548 |
| DOI: | 10.2337/diacare.25.6.965 |