A Clinical Audit: Aspirin Indication Amongst Patients Under Geriatric Teams – Is It Appropriate?

Abstract Background Aspirin is widely accepted as a key medication in the treatment of cardiovascular, cerebrovascular and peripheral vascular disease, with longstanding evidence supporting its use in the acute and secondary prevention setting. However, modern guidelines including the European society of cardiology guidelines supported by the ASPREE trial have not recommended its routine use in primary prevention due to adverse events. We aimed to assess aspirin indications amongst patients under Geriatric teams in a tertiary centre and associated rehabilitation centre. Methods An analysis was carried out by reviewing patient’s current medications while an inpatient. Data was collected by reviewing Kardex’s on a random day to see if patients were on aspirin and clarifying indication through reviewing clinical notes, as well as speaking to patients themselves. Exclusion criteria included age less than 70, as well as being an inpatient less than 5 days to allow time for adequate medication review. Results Across three wards consisting of 92 inpatient beds, 19 were noted to be on aspirin after exclusion criteria. 9 patients (47.5 percent) were noted to be on aspirin for primary prevention. 2 patients were noted to have dementia, with these patients at increased susceptibility to aspirin side effects (e.g. falls contributing to bleeding). A re audit carried out approximately 12 weeks after education session using above criteria showed 16 patients on aspirin, with three being on aspirin for primary prevention. Conclusion Aspirin is still being commonly used for primary prevention. Ongoing education regarding aspirin use given to primary and secondary care physicians would be greatly beneficial. Geriatricians and primary care physicians alike are instrumental in reducing potential adverse effects from regular medication review, as well as reducing polypharmacy incidence.