ArticleBMC family practice2003
Why are eligible patients not prescribed aspirin in primary care? A qualitative study indicating measures for improvement.
Article in BMC family practice, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect of low-dose aspirin on health outcomes: An umbrella review of systematic reviews and meta-analyses.British journal of clinical pharmacology · 2020Pooled it
- A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.BMC medical education · 2017Pooled it
- Effect of Low-Dose Aspirin on the Elderly.Cureus · 2024Review
- Trends in Provision of Medications and Lifestyle Counseling in Ambulatory Settings by Gender and Race for Patients With Atherosclerotic Cardiovascular Disease, 2006-2016.JAMA network open · 2023Article
- Aspirin Use, Compliance, and Knowledge of Anticancer Effect in the Community.The Permanente journal · 2020Observational
- Rationing and deprivation: disease-modifying therapies for multiple sclerosis in the United Kingdom.The European journal of health economics : HEPAC : health economics in prevention and care · 2013Article
- Understanding rational non-adherence to medications. A discrete choice experiment in a community sample in Australia.BMC family practice · 2012Article
- A taxonomy of reasons for not prescribing guideline-recommended medications for patients with heart failure.The American journal of geriatric pharmacotherapy · 2010Article
- Is There a Tension between Clinical Practice and Reimbursement Policy? The Case of Osteoarthritis Prescribing Practices in Ontario.Healthcare policy = Politiques de sante · 2007Article
- [Finding the right platelet anti-aggregant prescription for type-2 diabetes patients, according to the ADA 2003 criteria].Atencion primaria · 2006Article
- Prevalence of antiplatelet therapy in patients with diabetes.Cardiovascular diabetology · 2005Article
- Underutilization of aspirin persists in US ambulatory care for the secondary and primary prevention of cardiovascular disease.PLoS medicine · 2005Article
- Appropriate use of antiplatelets: is prescription in daily practice influenced by the global cardiovascular risk?European journal of clinical pharmacology · 2005Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite evidence-based guidelines, aspirin prescribing for the secondary prevention of stroke is sub-optimal. Little is known about why general practitioners do not prescribe aspirin to indicated patients. We sought to identify and describe factors that lead general practitioners (GPs) not to prescribe aspirin to eligible stroke patients. This was the first stage of a study exploring the need for and means of improving levels of appropriate aspirin prescribing.
methodQualitative interviews with 15 GPs in the West Midlands.
resultsInitially, many GPs did not regard their prescribing as difficult or sub-optimal. However on reflection, they gave several reasons that lead to them not prescribing aspirin for eligible patients or being uncertain. These include: difficulties in applying generic guidelines to individuals presenting in consultations, patient resistance to taking aspirin, the prioritisation of other issues in a time constrained consultation and problems in reviewing the medication of existing stroke patients.
conclusionIn order to improve levels of appropriate aspirin prescribing, the nature and presentation risk information available to GPs and patients must be improved. GPs need support in assessing the risks and benefits of prescribing for patients with combinations of complicating risk factors, while means of facilitating improved GP-patient dialogue are required to help address patient uncertainty. A decision analysis based support system is one option. Decision analysis could synthesise current evidence and identify risk data for a range of patient profiles commonly presenting in primary care. These data could then be incorporated into a user-friendly computerised decision support system to help facilitate improved GP-patient communication. Measures of optimum prescribing based upon aggregated prescribing data must be interpreted with caution. It is not possible to assess whether low levels of prescribing reflect appropriate or inappropriate use of aspirin in specific patients where concordance between the GP and the patient is practised.
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