{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T23:09:28Z","timestamp":1765667368926,"version":"3.48.0"},"reference-count":48,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,1,27]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the prevalence of off-label aspirin indications and the level of scientific support for off-label indications of aspirin in gynaecology and obstetrics outpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Two tertiary hospitals (a general hospital and a women and children\u2019s specialised hospital) in Xiamen, a city located on the southeastern coast of China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 4257 prescriptions were included for 2091 female patients aged &gt;18 who visited the gynaecology and obstetrics outpatient clinics and received aspirin treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The primary measure of this study was the proportion of off-label indications and of off-label indications supported by strong scientific evidence. Evidence from clinical guidelines and Micromedex is shown using descriptive statements. On-label indications of drugs in the same class as aspirin were also referred to for off-label aspirin use without strong evidence support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All indications of aspirin on outpatient prescriptions were determined as off-label use in this study. The most frequent off-label indication was recurrent miscarriage (2244 prescriptions, 52.71%). Totally, 30.94% of the prescriptions were supported by strong evidence for indications, including recurrent miscarriage with antiphospholipid syndrome and prophylaxis for pre-eclampsia. No drugs in the same class as aspirin had on-label indications for off-label aspirin use without strong evidence support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated that all indications of aspirin used in gynaecology and obstetrics outpatients at the two tertiary hospitals were off-label and not always supported by strong evidence, implicating that physicians should be cautious when issuing off-label prescriptions. More original clinical research on off-label aspirin use is needed to provide reference for routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050702","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T12:14:19Z","timestamp":1645445659000},"page":"e050702","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Off-label indications of aspirin in gynaecology and obstetrics outpatients at two Chinese tertiary care hospitals: a retrospective cross-sectional study"],"prefix":"10.1136","volume":"12","author":[{"given":"Sijie","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8710-1722","authenticated-orcid":false,"given":"Jianhui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingxian","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanni","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wubin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufang","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,2,21]]},"reference":[{"key":"2025121223514252000_12.2.e050702.1","first-page":"2006","article-title":"ASHP statement on the use of medications for unlabeled uses","volume":"49","year":"1992","journal-title":"Am J Hosp Pharm"},{"key":"2025121223514252000_12.2.e050702.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.9.1021"},{"key":"2025121223514252000_12.2.e050702.3","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.fertnstert.2015.01.019","article-title":"Off-label drug use in the treatment of polycystic ovary syndrome","volume":"103","author":"Vitek","year":"2015","journal-title":"Fertil Steril"},{"key":"2025121223514252000_12.2.e050702.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198363"},{"key":"2025121223514252000_12.2.e050702.5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001945"},{"key":"2025121223514252000_12.2.e050702.6","doi-asserted-by":"crossref","first-page":"200","DOI":"10.2174\/1574886313666180619120406","article-title":"Off-label use of drugs and adverse drug reactions in pediatric units: a prospective, multicenter study","volume":"13","author":"Pratico","year":"2018","journal-title":"Curr Drug Saf"},{"key":"2025121223514252000_12.2.e050702.7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1001\/jamainternmed.2015.6058","article-title":"Association of off-label drug use and adverse drug events in an adult population","volume":"176","author":"Eguale","year":"2016","journal-title":"JAMA Intern Med"},{"key":"2025121223514252000_12.2.e050702.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j603"},{"key":"2025121223514252000_12.2.e050702.9","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1051"},{"key":"2025121223514252000_12.2.e050702.10","doi-asserted-by":"crossref","unstructured":"Yang J , Lin W , Chen Y . 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