Patient Self-Medication with ASA 81 mg

Abstract

Purpose: Low-dose acetylsalicylic acid (ASA) is an important therapy for decreasing cardiac events in patients at risk. The initiation of ASA therapy should involve physician assessment, but some people may choose to self-medicate. The purpose of this project was to determine the percentage of people taking ASA 81 mg without the recommendation of their doctor, as well as to estimate the proportion of users exhibiting an objective indication for daily use of ASA 81 mg, based on survey responses indicating the presence of established cerebrovascular disease (stroke or mini-stroke), coronary heart disease (CHD) (heart attack or prevention surgery), a CHD risk equivalent (diabetes) or at least 2 risk factors for CHD (age, smoking, high blood pressure, high cholesterol or positive family history). Methods: A 1-page survey was distributed to purchasers of ASA 81 mg at 52 community pharmacies in Saskatchewan. Respondents were asked who led them to start taking ASA for heart health and were asked for information on their age and health history. Estimates were made of the proportion of users exhibiting an objective indication for daily use of ASA 81 mg, defined as the presence of either established cerebrovascular disease (stroke or mini-stroke), coronary heart disease (CHD) (heart attack or prevention surgery), a CHD risk equivalent (diabetes) or at least 2 risk factors for CHD (age, smoking, high blood pressure, high cholesterol or positive family history). Results: Of the 481 respondents whose surveys were suitable for analysis, 417 (86.7%) were engaged in doctor-supervised care. Conversely, 13.1% did not seek a physician's advice prior to the initiation of therapy. Of the 69 respondents who were taking ASA but did not meet the indications for its use, the majority claimed to have started therapy based on the recommendation of a health care professional. Conclusion The use of ASA without physician intervention is of serious concern. In this study of Saskatchewan citizens, up to 13.1% did not involve their doctor for initiation of therapy, potentially exposing them to unnecessary risk.