Background:The U.S. Preventive Services Task Force (USPSTF) recommendations for cardiovascular disease(CVD) includes aspirin for primary prevention and abdominal aortic aneurysms (AAA)screening . USPSTF recommends that men ages 45 to 79 years and women ages 55 to 79 years should be prescribed aspirin to prevent cardiovascular events. USPSTF also recommends one-time screening for AAA with ultrasonography in men ages 65 to 75 years who have ever smoked.We sought to evaluate the adoption of aspirin use and AAA screening per USPSTF recommendations in a primary care setting at an urban academic teaching hospital.
Methods and Results: We obtained data for aspirin use and AAA screening by chart review of patients seen in primary care continuity clinic by internal medicine resident physicians in their first and second year of training, between August - October, 2014. A total of 626 charts were reviewed to identify patient who needs primary prevention per USPSTF (men 45 -79 years and women 55- 79 years of age). This resulted in a study population of 388 patients which comprised of 219 men and 169 women. Comorbid conditions in this patient population included hypertension (69.3%), diabetes mellitus (28.10%), dyslipidemia (39%), smoking (37.9%) and obesity. Only 150 (38.7%) of the 388 patients were appropriately placed on aspirin per USPSTF recommendations. Moreover only 13% of patients were appropriately screened for AAA (Table 1).
Conclusion: Adoption of USPSTF recommendations for aspirin use for primary prevention of CVD and AAA screening is under implemented even in an academic teaching environment. Our results indicate that there is an urgent need for implementation strategies to improve the adoption of these recommendations.
Table 1: Patient characteristics and screening percentage