Quality improvement effort tied to decrease in major bleeding without increase in thrombotic events
FRIDAY, Sept. 23, 2022 (HealthDay News) — Cutting aspirin use among patients treated with concomitant warfarin and lacking a clear indication for using both is associated with improved clinical outcomes, according to a study published online Sept. 19 in JAMA Network Open.
Jordan K. Schaefer, M.D., from University of Michigan in Ann Arbor, and colleagues assessed changes in aspirin use, bleeding, and thrombosis event rates among patients treated with warfarin. Preassessment and postassessment occurred as part of a six-center quality improvement collaborative in Michigan among 6,738 adults taking warfarin for atrial fibrillation and/or venous thromboembolism without an apparent indication for concomitant aspirin.
The researchers found that aspirin use decreased slightly from a baseline mean use of 29.4 percent to 27.1 percent during the 24 months before the intervention, with an accelerated decrease after the intervention (mean aspirin use, 15.7 percent). The intervention was associated with a significant decrease in major bleeding events per month (0.31 and 0.21 percent preintervention and postintervention, respectively). There was no change observed in mean percentage of patients having a thrombotic event from before versus after the intervention (0.21 versus 0.24 percent).
“This study suggests that an anticoagulation clinic-based aspirin deimplementation intervention can improve guideline-concordant aspirin use,†the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.
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