ArticlePLoS medicine2005
Underutilization of aspirin persists in US ambulatory care for the secondary and primary prevention of cardiovascular disease.
Article in PLoS medicine, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 69 citations in OpenAlex.
- Chemoprevention of colorectal cancer in individuals with previous colorectal neoplasia: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2016Pooled it
- Evaluating an implementation strategy in cardiovascular prevention to improve prescribing of statins in Germany: an intention to treat analysis.BMC public health · 2013Trial
- Comparison of the racial/ethnic prevalence of regular aspirin use for the primary prevention of coronary heart disease from the multi-ethnic study of atherosclerosis.The American journal of cardiology · 2011Trial
- 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
- A longitudinal study to evaluate the bleeding pattern of patients on low dose aspirin therapy following dental extraction.Journal of family medicine and primary care · 2021Article
- Aspirin use for cardiovascular disease prevention in the uninsured population.SAGE open medicine · 2020Article
- Aspirin Use, Compliance, and Knowledge of Anticancer Effect in the Community.The Permanente journal · 2020Observational
- Low-Dose Aspirin for Primary Prevention of Cardiovascular Disease: Use Patterns and Impact Across Race and Ethnicity in the Southern Community Cohort Study.Journal of the American Heart Association · 2019Article
- Aspirin Use for Primary and Secondary Prevention in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Patients.Open forum infectious diseases · 2014Article
- Aspirin for primary prevention: a challenging decision.Journal of the American Heart Association · 2014Article
- Use of aspirin for primary and secondary cardiovascular disease prevention in the United States, 2011-2012.Journal of the American Heart Association · 2014Article
- Confirmation of reported aspirin use in community studies: utility of serum thromboxane B2 measurement.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2014Article
- Review
- Medication effectiveness may not be the major reason for accepting cardiovascular preventive medication: a population-based survey.BMC medical informatics and decision making · 2012Article
- Nonsteroidal anti-inflammatory drug and acetaminophen use and risk of adult myeloid leukemia.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2011Article
- Quality of US primary care delivered by resident and staff physicians.Journal of general internal medicine · 2010Article
- Risk assessment and aspirin use in Asian and Western populations.Vascular health and risk management · 2010Review
- Racial and ethnic disparities in cardiovascular medication use among older adults in the United States.Pharmacoepidemiology and drug safety · 2010Article
- Potential use of 10-year and lifetime coronary risk information for preventive cardiology prescribing decisions: a primary care physician survey.Archives of internal medicine · 2010Article
- Use of antithrombotic agents among U.S. stroke survivors, 2000-2006.American journal of preventive medicine · 2010Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDespite the proven benefits of aspirin therapy in the primary and secondary prevention of cardiovascular disease (CVD), utilization rates of aspirin remain suboptimal in relation to recommendations. We studied national trends of aspirin use among intermediate- to high-risk patients in the US ambulatory care settings and compared the priority given to aspirin versus statins for CVD risk reduction. We also examined patient and health care provider contributors to the underuse of aspirin. METHODS AND
findingsWe used the 1993-2003 US National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to estimate aspirin use by cardiovascular risk. Physician-noted cardiovascular diseases defined high risk. Intermediate risk was defined as having diabetes mellitus or multiple major risk factors. The proportion of patient visits in which aspirin was reported increased from 21.7% (95% confidence interval: 18.8%-24.6%) in 1993-1994 to 32.8% (25.2%-40.4%) in 2003 for the high-risk category, 3.5% (2.0%-5.0%) to 11.7% (7.8%-15.7%) for visits by patients diagnosed with diabetes, and 3.6% (2.6%-4.6%) to 16.3% (11.4%-21.2%) for those with multiple CVD risk factors. Beginning in 1997-1998, statins were prioritized over aspirin as prophylactic therapy for reducing CVD risk, and the gaps remained wide through 2003. In addition to elevated CVD risk, greater aspirin use was independently associated with advanced age, male gender, cardiologist care, and care in hospital outpatient departments.
conclusionImprovements in use of aspirin in US ambulatory care for reducing risks of CVD were at best modest during the period under study, particularly for secondary prevention, where the strongest evidence and most explicit guidelines exist. Aspirin is more underused than statins despite its more favorable cost-effectiveness. Aggressive and targeted interventions are needed to enhance provider and patient adherence to consensus guidelines for CVD risk reduction.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.