Abstract
BackgroundType 2 diabetes is associated with an increased cardiovascular risk. Use of aspirin has been shown to be of benefit for secondary prevention of cardiovascular disease in patients with type 2 diabetes; benefits in primary prevention have not been clearly proven.AimsThis study aims to (a) determine if aspirin is prescribed appropriately in type 2 diabetes for primary or secondary prevention of cardiovascular disease (CVD) and (b) evaluate whether there are differences in aspirin prescribing according to where people receive their care.DesignCross-sectional studyMethodsThe medical records of individuals with type 2 diabetes aged over 18 years and attending Elmwood Primary Care Centre and Cork University Hospital Diabetes outpatient clinics (n = 400) between February and August 2017 were reviewed.ResultsThere were 90 individuals exclusively attending primary care and 310 persons attending shared care. Overall, 49.0% (n = 196) of those were prescribed aspirin, of whom 42.3% were using it for secondary prevention. Aspirin was used significantly more in people attending shared care (p < 0.001). About 10.8% of individuals with diabetes and CVD attending shared care met guidelines for, but were not prescribed aspirin.ConclusionA significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. In contrast, a substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention.
Highlights
Type 2 diabetes mellitus is a chronic condition associated with multiple complications and comorbidities
This study aims to investigate the appropriateness of aspirin prescribing in type 2 diabetes by (a) comparing aspirin prescribing in a primary and secondary care setting and (b) determining whether aspirin is being used for primary or secondary prevention of cardiovascular disease (CVD)
All CVD patients under GP care were on aspirin or other antiplatelet/anticoagulant, while 10.4% of participants under shared care had CVD but were not on any antiplatelet or anticoagulant
Summary
Type 2 diabetes mellitus is a chronic condition associated with multiple complications and comorbidities. Use of aspirin has been shown to be of benefit for secondary prevention of cardiovascular disease in patients with type 2 diabetes; benefits in primary prevention have not been clearly proven. Aims This study aims to (a) determine if aspirin is prescribed appropriately in type 2 diabetes for primary or secondary prevention of cardiovascular disease (CVD) and (b) evaluate whether there are differences in aspirin prescribing according to where people receive their care. About 10.8% of individuals with diabetes and CVD attending shared care met guidelines for, but were not prescribed aspirin. Conclusion A significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. A substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention
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