Assessment of low dose aspirin use for prevention of Cardiovascular disorders and associated factors among Diabetic out-patients at jimma medical center

Abstract

Background: Cardiovascular diseases are the most common causes of mortality and morbidity among diabetic patients. Aspirin is recommended for primary and secondary prevention of cardiovascular events in diabetic patients who are eligible for therapy based on active international guidelines. However, these active guidelines are underutilized in these patients. Objective: To assess low dose aspirin use and associated factors among diabetic patients on follow-up at the diabetes clinic of Jimma Medical Center. Method: A cross-sectional study was conducted among 387 diabetic patients on follow-up at the diabetes clinic of Jimma Medical Center from October 1, 2020-November 15, 2020. The collected data were cleaned, entered into EpiData version 4.6 and was analyzed using STATA version 16.0. Descriptive statistics and multivariable logistic regression was employed to identify the relationship between dependent and independent variables. Result: Out of the total (387) diabetic patients interviewed 35.8% of them were 50-64 years old. About half (48.7%) of them had a history of hypertension and 30.1% of them had a history of dyslipidemia. A large proportion (47.2%) of the participants was utilizing a low dose aspirin. Among the patients on low dose aspirin, 41.9% of clients are taking aspirin without an indication for primary prevention, while 25.9% of diabetic patients having an indication to use aspirin were not using as per active guideline. Diabetic patients who live with DM for 2-4 years duration [AOR 3.95 (95% C.I. 1.59, 9.82)], those who live 5-9 years [AOR 5.72 (95% C.I 3.04, 8.09)], 10- 14 years [AOR 6.25 (95% C.I. 2.33, 16.75)], and 15 years and above years [AOR 3.49 (95% C.I. 1.30, 9.35)], as compared to less than 2 years. Those in the age group of 40-49 years, 50-64 years, and 65 years above were 3.99, 7.28, and 8.51 more likely to utilize a low dose of aspirin as compared to those under 30 years age. Participants who have a history of hypertension [AOR 1.97 (95% C.I 1.11, 3.50)] and those who have dyslipidemia [AOR 3.07 (95% C.I 1.60, 5.90)] are more likely to utilize a low dose of ASA compared to their counterparts. Conclusion: A high proportion of DM patients on follow-up were using a low dose aspirin without indications as per active guidelines. Duration of diabetes, age, having hypertension and dyslipidemia were significant factors influencing use of low dose aspirin Therefore, health workers shall follow these guidelines for use of low dose aspirin for primary and secondary prevention . Even though further studies on determinants of low dose of aspirin use and its consequences on longitudinal base is needed, appropriate information, education, and communication shall be disseminated for diabetic patients to increase awareness on the use of aspirin