1046 Assessing compliance to daily low dose aspirin for preeclampsia prevention using a validated questionnaire

Abstract

Adherence is essential to the efficacy of ASA in preventing preeclampsia (PE). Our objective was to evaluate and compare the adherence of pregnant women at high risk for PE to different regimens of ASA using a validated questionnaire, the simplified medication adherence questionnaire (SMAQ). 33 pregnant women identified as high risk for developing PE using the Unites States Preventative Services Task Force (USPSF) criteria were randomized in an open-label setting to either ASA 81mg daily or ASA 162mg daily, to be initiated before 16 weeks’ gestation. The USPSF criteria include: PE in a prior pregnancy, chronic hypertension, pregestational diabetes, renal disease, autoimmune disease or multifetal gestation. Compliance to therapy was ascertained using the validated SMAQ at 20, 26 and 36 ± 2 weeks’ gestation (Table 1). Non-adherence was defined as: a positive response to any of the qualitative questions, >2 missed doses over the past week, or >2 days of non-use in the past 3 months. Compliance rates were compared across treatment groups using Chi-square with an alpha error level set at <0.05. The mean age of participants was 36.0±4.9 years, 16/33 (48.5%) were primiparous. Age and parity were similar for both treatment groups. 18/33 (54.5%) women were randomized to the ASA 81mg group and 15/33 (45.5%) to ASA 162mg. The SMAQ was completed by 93.9% of participants at 20±2 weeks, 87.9% at 26±2 weeks and 75.8% at 36±2 weeks. Table 2 outlines compliance rates with daily low dose aspirin, stratified by treatment group. Overall, medication adherence was higher in the ASA 81mg group, particularly after the mid-trimester. Reasons for non-adherence included gastrointestinal side effects (6.1%), vaginal spotting (3%) and non-intentional omission (9.1%). Aspirin compliance appears to be elevated in women at high risk for PE who are prescribed ASA 81mg daily and to be significantly lower in women on 162mg. This should be taken into consideration when prescribing and counseling women about low dose ASA for PE prevention.View Large Image Figure ViewerDownload Hi-res image Download (PPT)