Semergen · 2026
[Evaluation of the effectiveness of an intervention for the deprescription of aspirin in primary prevention of cardiovascular diseases].
Контролируемое клиническое исследованиеАннотация на английскомСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Hernández Girbés A, Moral I, Bruning González P, Cuixart L, Chaboun N, Hernández M, Sánchez D, Reyes C, Brotons C, en nombre del grupo DEPRESASP
Аннотация
OBJECTIVE: The use of aspirin in primary prevention of cardiovascular diseases is considered, according to the existing scientific evidence today, as a clinical practice of low value. The objective of this study is to evaluate the effectiveness of an intervention for its deprescription in primary care.
METHODS: A quasi-experimental before-and-after study was conducted, without a control group. All adult patients from three urban primary care centers who were prescribed low-dose aspirin for primary prevention of cardiovascular diseases were selected. The intervention consisted of an informational session for the medical team, where the current evidence and recommendations regarding aspirin treatment and the need for deprescription in cases of potentially inappropriate treatment were explained.
RESULTS: A total of 533 patients were being treated with low-dose aspirin. There were 16 (3.0%) recorded deaths. The mean age was 74.3 (SD: 14.0), and 58.5% were women. In 302 (58.4%) patients, the treatment was deemed appropriate by medical criteria, 26 (5.0%) refused deprescription, and 44 (8.5%) patients were not found. Ultimately, aspirin was effectively deprescribed in 145 patients (28.0%). The effective deprescription rate was higher in older patients and those at very high cardiovascular risk (34.02%), followed by patients at high cardiovascular risk (26.80%).
CONCLUSIONS: An absolute reduction of 28% in the inappropriate use of aspirin for primary prevention of cardiovascular diseases was observed. The proposed intervention could easily be extrapolated to other primary health care centers.
METHODS: A quasi-experimental before-and-after study was conducted, without a control group. All adult patients from three urban primary care centers who were prescribed low-dose aspirin for primary prevention of cardiovascular diseases were selected. The intervention consisted of an informational session for the medical team, where the current evidence and recommendations regarding aspirin treatment and the need for deprescription in cases of potentially inappropriate treatment were explained.
RESULTS: A total of 533 patients were being treated with low-dose aspirin. There were 16 (3.0%) recorded deaths. The mean age was 74.3 (SD: 14.0), and 58.5% were women. In 302 (58.4%) patients, the treatment was deemed appropriate by medical criteria, 26 (5.0%) refused deprescription, and 44 (8.5%) patients were not found. Ultimately, aspirin was effectively deprescribed in 145 patients (28.0%). The effective deprescription rate was higher in older patients and those at very high cardiovascular risk (34.02%), followed by patients at high cardiovascular risk (26.80%).
CONCLUSIONS: An absolute reduction of 28% in the inappropriate use of aspirin for primary prevention of cardiovascular diseases was observed. The proposed intervention could easily be extrapolated to other primary health care centers.