HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Krein, S. L. Articles by Kerr, E. A. Search for Related Content PubMed PubMed Citation Articles by Krein, S. L. Articles by Kerr, E. A. Social Bookmarking                What's this?

Aspirin Use and Counseling About Aspirin Among Patients With Diabetes

¹ Department of Veterans Affairs’ Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
² Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
³ Michigan Diabetes Research and Training Center, Ann Arbor, Michigan
⁴ VA New Jersey Healthcare System, East Orange, New Jersey
⁵ University of Medicine and Dentistry of New Jersey, Newark, New Jersey

OBJECTIVE—Despite being a safe, effective therapy for lowering cardiovascular risk, only 20% of diabetic patients were using aspirin in the early 1990s. This study examines current physician practices and the use of aspirin therapy by individuals with diabetes.

RESEARCH DESIGN AND METHODS—A random sample of diabetic patients receiving care in the Department of Veterans Affairs health care system were surveyed during January-March 2000. The association between aspirin counseling, aspirin use, and reported coronary vascular disease (CVD) and classical CVD risk factors were examined using logistic regression. The effect of increasing aspirin use on risk of myocardial infarction (MI) and cardiovascular mortality was demonstrated by simulation.

RESULTS—Seventy-one percent of respondents reported being counseled about aspirin use, and 66% were taking daily aspirin. Individuals with known CVD were more likely to be counseled (odds ratio [OR] 4.9, 95% CI 2.9–8.1) and to use aspirin (2.1, 1.2–3.7). The factor most strongly associated with aspirin use was having been counseled about aspirin therapy by a doctor. We estimate that for this population, increasing daily aspirin use to 90% could prevent an additional 11,000 MIs and potentially save >8,000 lives.

CONCLUSIONS—Compared with previous reports, a substantial proportion of these diabetic patients have been counseled about and use aspirin. Most clinicians recognize aspirin as an important treatment for patients with preexisting coronary disease. However, since diabetes is now considered a CVD equivalent, it is imperative that clinicians include counseling about aspirin therapy as a care priority for all their diabetic patients, as this simple intervention may prevent many cardiovascular events and deaths.

Abbreviations: CVD, coronary vascular disease • DQIP, Diabetes Quality Improvement Project • MI, myocardial infarction • OR, odds ratio • VA, Veterans Affairs • VISN, veterans integrated service network

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. C. O'Connor, C. L. Sherry, C. B. Guest, and G. G. Freund Type 2 Diabetes Impairs Insulin Receptor Substrate-2-Mediated Phosphatidylinositol 3-Kinase Activity in Primary Macrophages to Induce a State of Cytokine Resistance to IL-4 in Association with Overexpression of Suppressor of Cytokine Signaling-3 J. Immunol., June 1, 2007; 178(11): 6886 - 6893. [Abstract] [Full Text] [PDF]

				T. S. Tang, M. L. Gillard, M. M. Funnell, R. Nwankwo, E. Parker, D. Spurlock, and R. M. Anderson Developing a New Generation of Ongoing Diabetes Self-management Support Interventions: A Preliminary Report The Diabetes Educator, January 1, 2005; 31(1): 91 - 97. [Abstract] [Full Text] [PDF]

				S. D. Persell and D. W. Baker Aspirin Use Among Adults With Diabetes: Recent Trends and Emerging Sex Disparities Arch Intern Med, December 13, 2004; 164(22): 2492 - 2499. [Abstract] [Full Text] [PDF]

				V. M. Montori, S. C. Bryant, A. M. O'Connor, N. W. Jorgensen, E. E. Walsh, and S. A. Smith Decisional Attributes of Patients With Diabetes: The aspirin choice Diabetes Care, October 1, 2003; 26(10): 2804 - 2809. [Abstract] [Full Text] [PDF]

				M. Heisler, D. M. Smith, R. A. Hayward, S. L. Krein, and E. A. Kerr How Well Do Patients' Assessments of Their Diabetes Self-Management Correlate With Actual Glycemic Control and Receipt of Recommended Diabetes Services? Diabetes Care, March 1, 2003; 26(3): 738 - 743. [Abstract] [Full Text] [PDF]