Factors that influence the implementation of the guidelines for aspirin use by diabetic patients in Israel

BACKGROUND: Aspirin use by diabetic patients, both as secondary and tertiary prevention, significantly reduces cardiovascular events. The Israeli Diabetes Association guidelines, published in 2005, recommend that all diabetic patients, at increased risk for cardiovascular events, take aspirin. AIMS: The aim of this study was to identify factors which influence the implementation of the guidelines for aspirin use by diabetic patients in Israel. METHODS: The medical records of 100 diabetic patients were reviewed in a cross sectional study conducted among patients of 4 family practitioners in a primary care clinic in Tel Aviv. Statistical analyses were performed to identify the relation between aspirin use, and medical and personal data of the diabetic patients. RESULTS: Among 100 diabetic patients, sixty one (61%) were prescribed aspirin. Prescription rate among men (60%) and women (62%) was similar. Patients who were not prescribed aspirin were younger on average (p < 0.02). Prescription of aspirin was more common as tertiary rather than secondary prevention, i.e. among patients who already showed signs of cardiovascular disease (p < 0.003). The prescription rates for aspirin were lower than for statins and ACE-inhibitors. CONCLUSIONS: Aspirin use among diabetic patients in Tel Aviv is relatively high and similar to that in other western countries. However, the relatively lower use of aspirin for secondary prevention, especially among younger patients, deserves attention.