Knowledge, attitudes and current practice of Jordanian family physicians about prescribing aspirin in primary and secondary prevention of vascular diseases: a self-reported survey

Abstract

Long-term aspirin therapy is crucial for patients with increased risk of occlusive vascular diseases. However, inconsistencies in the methods for risk assessment and the perception among health care providers are major contributing factors for challenges in risk assessment. A questionnaire was distributed to a total of 124 family physicians working at two university teaching centers and Ministry of Health primary health care centers in Jordan. A majority of the physicians reported prescribing aspirin for patients if they have peripheral vascular disease (93%), post-coronary artery bypass graft (92%), stroke (90%), or stable angina (95%). A smaller percentage of physicians reported that they prescribe aspirin if patients have atrial fibrillation (81%) or acute myocardial infarction (85%). The percentage of physicians who prescribe aspirin markedly declined when patients have potential bleeding disorder (52%) or asthma (52%). For patients without cardiovascular diseases but with one or more risk factors, the prophylactic use of aspirin was reported by 85% to 95% of family physicians. The presence of co-morbidity along with vascular diseases tended to hinder physicians from prescribing aspirin even when it is indicated. A majority of family physicians recommends the use of aspirin in primary prevention in spite of its questionable or even negative benefits. Furthermore, self-reported aspirin prescribing rates among physicians in Jordan are higher than those reported by physicians in the U.S. and Europe. Therefore, we believe that proper dissemination of updated evidence-based treatment guidelines is required to ensure appropriate and efficient preventive services for cardiovascular diseases.