Aspirin usage in a large teaching hospital diabetes clinic setting

Aim To document aspirin usage and the prevalence of large and small vessel complications in patients with diabetes mellitus (DM) attending the outpati ent diabetes clinics of a large public hospital. Methods All patients attending diabetes outpatient clinics at The Royal Mel bourne Hospital in Melbourne, Australia were surveyed over a 3-month period . Results Complete data were available on 629 of 632 (296 male) patients surv eyed. Of the 29.3% of patients who were suffering from one or more macrovas cular complication (ischaemic heart disease, cerebrovascular disease or per ipheral vascular disease), 63% were currently on aspirin treatment. Of thos e not on aspirin, 65% had no contra-indication to aspirin treatment and a f urther 19% had only a relative contra-indication of either aspirin or warfa rin treatment recorded. Conclusions The published recommendations for the use of aspirin in patient s with macrovascular disease were generally being followed in this clinic-b ased population. However, a significant proportion of patients without a co ntraindication to treatment were still not receiving aspirin. The lack of c lear evidence-based guidelines for aspirin use may be a factor in its under prescription. This survey suggests clear evidence-based guidelines should b e established and disseminated.