Abstract 2334: Consumer Survey Indicates Aspirin Use Remains Less Than Optimal in Stroke Survivors
Background: Low-dose aspirin is recommended for the secondary prevention of ischemic stroke or TIA. With the availability of aspirin (ASA) over-the-counter, actual ASA use and regimens are difficult to determine using insurance claims databases. Likewise physician involvement in ASA therapy is not captured. In the recent Agency for Healthcare Research and Quality (AHRQ) survey, ASA use among stroke survivors was reported, but there were no data on ASA dosing regimens or provider recommendations.
Methods: In December 2009, an internet-based questionnaire was completed using a consumer internet panel of 23,139 US households (HHs) with an individual/caretaker of an individual who had suffered stroke and/or myocardial infarction (MI). After confirming that the HH had someone who met the diagnostic criteria, random sampling was performed to obtain 500 individuals with either previous stroke only or stroke + MI and 500 individuals with previous MI only who were currently taking ASA as a result of their condition.
Results: A random sample of 1579 HHs were screened, yielding 842 total stroke and 737 MI only HHs. Aspirin was not used for stroke or MI in 411 of these HHs (342 total stroke and 69 MI only). The remaining 500 stroke HHs and 500 of the 668 MI only HHs (168 HHs terminated when MI only quota filled) were included in the analysis. Use of ASA for secondary prevention of was 59% (500/842) for total stroke sufferers compared with 83% (650/785) for total MI sufferers. At least 91% of stroke (445/488) or MI (466/496) survivors reported taking ASA precisely as recommended by their physician. The most common dosing regimen was ASA 81 mg once daily, followed by 325 mg once daily.
Conclusions: Aspirin use among patients with previous stroke was <60% in this 2009 internet-based survey, which is similar to the results of the recent AHRQ survey (57% ASA use among US stroke survivors over the 7-year period of 2000-2006.) Stroke patients identified cardiologists and GPs as their primary healthcare provider, and these two physician groups are the most frequent recommenders of ASA therapy to this patient population. Taken together, these findings suggest that continued effort is needed to optimize the use of ASA therapy in secondary stroke prevention as recommended by current guidelines.
- © 2012 by American Heart Association, Inc.