226 DUAL ANTI-PLATELET THERAPY: AUDIT OF COMMUNICATION OF DIAGNOSIS AND DURATION ACROSS PRIMARY AND SECONDARY CARE

Abstract

Abstract Background Dual Anti-Platelet Therapy (DAPT) is indicated in vascular disease & duration of treatment depends on factors such as indication, age, bleeding risk, disease severity & co-morbidities. Inappropriately prolonged DAPT may increase the risk of major bleeding without a reduction in all-cause mortality and decisions for the duration of DAPT are best made by specialists in secondary care which should be communicated definitively to partners in primary care. Methods A retrospective search of patients prescribed Aspirin and a PY2 inhibitor from 01/01/2020 to 30/04/2022 was conducted. Patients were excluded if DAPT was not prescribed concurrently or if the patient deceased before the duration of DAPT had passed. Each record was evaluated to determine if: (1) Secondary care correspondence stated indication & duration of treatment; (2) Patients had stop dates for DAPT on their prescription; (3) Patients had been on DAPT for correct duration and (4) Any errors/improvements were identified. Results Number of patients met criteria = 81, Average Age = 69.7yrs, Male = 58%, Female = 42%. 12% of letters from Secondary Care did not specify a duration. 43% did not have a stop date on their prescriptions. 19% prescribed DAPT for the incorrect duration. 15% classified as having a serious medication error (DAPT >3yrs, No obvious indication for DAPT, DAPT & Antithrombotic therapy without review). 14.8% not prescribed a PPI & 4.9% admitted to hospital with a GI bleed. 24.7% Patients prescribed Esomeprazole/Omeprazole & Clopidogrel Conclusion DAPT is an important pharmacotherapy intervention in the treatment of vascular disease, but it's duration should be regularly assessed by specialists and clearly communicated to prescribers in Primary care to optimise treatment and reduce bleeding risk. Clinical system warnings have now been utilised to alert prescribers to well defined time limits of DAPT and patients on less appropriate PPI's have been switched. Secondary care colleagues have been reminded of the importance of clear and concise communication of clinical interventions and plans.