Does professional advice influence aspirin use to prevent heart disease in an HMO population?

Abstract

OBJECTIVE: Aspirin use seems to reduce coronary artery disease events in some groups of patients. Factors associated with use of aspirin to prevent heart disease in an HMO population were examined. DESIGN: A population-based survey. SETTING: A large HMO in the midwestern United States. PARTICIPANTS: 8000 health plan members 40 years of age and older. MAIN OUTCOME MEASURES: The survey assessed use of aspirin, professional advice to use aspirin, and coronary heart disease risk factors and status. The sample was stratified by whether members had none, one, or more than one of the following chronic conditions: diabetes, hypertension, lipid disorder, or heart disease. The mailed survey had a corrected response rate of 82.4%. RESULTS: Overall, 38% of respondents reported using aspirin at least three times a week to prevent heart disease. Aspirin use did not vary in owned versus contracted clinics. Aspirin use was 71.3% in patients with and 27.7% in patients without diagnosed coronary heart disease (P < 0.001). In logistic regression models, professional advice to take aspirin was strongly associated with self-reported use of aspirin (odds ratio, 13.86) (P < 0.001) after adjustment for age, sex, level of education, and chronic disease status. CONCLUSIONS: Aspirin is widely used by HMO members with coronary artery disease to prevent subsequent coronary artery disease events. Professional advice to use aspirin seems to be strongly related to aspirin use.