Strategy to Improve Safety in the Prescription of High Doses of Acetylsalicylic Acid in Primary Care
DOI:
https://doi.org/10.60103/phc.v25i3.794Keywords:
acetylsalicylic acid; STOPP-START criteria; primary care pharmacistAbstract
Objective: A study was proposed whose main objective was to evaluate the variation in the number of patients aged ≥74 years in chronic treatment with high doses of acetylsalicylic acid (ASA) (> 150 mg), after a primary care pharmacist intervention strategy.
Methods: It was carried out a cross-sectional and interventional study in ≥74 years old patients treated with ASA >150 mg, dispensed in a period of 6 months (January-July 2021), in 40 health centers.
Results: the total number of patients was 731. 56.6% women, mean age=85.0 years (95% CI 84.6-85.5); mean years on treatment with ASA > 150 mg = 6.5 (95% CI 6.2-6.8). A dose reduction was achieved in 394 patients (53.9%; 95% CI 50.2-57.6). The total number of patients and percentage in which the acceptance of the intervention was greater than 50% according to the diagnosis was: venous insufficiency (n=8; 87.5%), venous thrombotic disease (n=4; 75.0%), uncertain diagnosis (n=56; 69.6%), atrial fibrillation (n=25; 64.0%), primary prevention of cardiovascular disease (n=102; 62.7%), peripheral artery disease (n=22 54.5%), stroke (n= 362, 51.7%). 17.2% were not receiving concomitant treatment with a PPI. (IC)
Conclusions: despite of the scientific evidence, prescription of a high dose of ASA is still occurring in older patients, increasing bleeding risk without any benefit. This strategy was effective since ASA dose was adjusted in more than half of the affected patients. Primary Care Pharmacists can play an important role in the detection and resolution of potential adverse effects.
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Copyright (c) 2023 Eva Prieto Utiel, Esther Trillo Gallo, Mª José Almodóvar Carretón, Blanca Basagoiti Carreño, M Carmen Herrero Domínguez-Berrueta , Ana Gangoso Fermoso , Mª Luisa Ibarra Mira , Ana Díez Alcántara
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