{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:25:49Z","timestamp":1792013149048,"version":"4.4.0"},"reference-count":17,"publisher":"American Society of Consultant Pharmacists","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"Background<\/jats:bold> National guidelines no longer recommend adults 60 years of age and older to begin treatment with low-dose daily aspirin for primary prevention of atherosclerotic cardiovascular disease (CVD) due to a lack of proven net benefit and a higher risk of bleeding.\n Objective<\/jats:bold> The objective of this cross-sectional retrospective analysis was to evaluate the appropriateness of low-dose aspirin prescribing and subsequent gastrointestinal bleeding in older persons receiving primary care in a large academic health system. Setting<\/jats:bold>\n Large, academic health system within Colorado. Patients<\/jats:bold> Patients with an active order for daily low-dose aspirin as of July 1, 2021, were assessed for appropriateness based on indication (primary vs secondary prevention) and use of a concomitant proton-pump inhibitor\n (PPI). Incident gastrointestinal bleeds (GIBs) in the subsequent 12 months and GIB risk factors were also evaluated. Results<\/jats:bold> A total of 19,525 patients were included in the analysis. Eighty-nine percent of patients identified as White and 54% identified as male. Of the\n total cohort, 44% had CVD and 19% were co-prescribed a PPI. GIB occurred in 247 patients (1.27%) within the subsequent year. Risk factors significantly associated with a GIB within 1 year included: history of GIB, history of peptic ulcer disease, other esophageal issue (esophagitis, Barrett\u2019s\n esophagus, Mallory Weiss tears, etc.), 75 years of age or older, and history of gastroesophageal reflux disease. Conclusion<\/jats:bold> This evaluation found that many older persons at this institution may be inappropriately prescribed aspirin, providing opportunities for pharmacists\n to improve medication safety by deprescribing aspirin among primary prevention patients or potentially co-prescribing a PPI in secondary prevention patients.<\/jats:p>","DOI":"10.4140\/tcp.n.2024.218","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T04:30:36Z","timestamp":1716870636000},"page":"218-227","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Aspirin Prescribing and Gastrointestinal Bleeding in Adults 60 Years of Age and Older in a Large, Academic Health System"],"prefix":"10.4140","volume":"39","author":[{"given":"Kristin L.","family":"Potthast","sequence":"first","affiliation":[{"name":"1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Billups","sequence":"additional","affiliation":[{"name":"1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle R.","family":"Fixen","sequence":"additional","affiliation":[{"name":"1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Titus","sequence":"additional","affiliation":[{"name":"1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J.","family":"Saseen","sequence":"additional","affiliation":[{"name":"1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunny A.","family":"Linnebur","sequence":"additional","affiliation":[{"name":"1 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2625","reference":[{"key":"ref1","first-page":"93","article-title":"Heart disease and stroke statistics\u20142023 update: a report from the American Heart Association.","volume":"147","year":"2023","journal-title":"Circulation."},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1001\/jama.2022.4983","article-title":"Aspirin use to prevent cardiovascular disease: US Preventive Services Task Force recommendation statement.","volume":"327","year":"2022","journal-title":"JAMA."},{"key":"ref3","doi-asserted-by":"crossref","first-page":"836","DOI":"10.7326\/M16-0577","article-title":"Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement.","volume":"164","year":"2016","journal-title":"Ann Intern Med."},{"key":"ref4","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1111\/jgs.18372","article-title":"American Geriatrics Society 2023 updated AGS Beers Criteria\u00ae for potentially inappropriate medication use in older adults.","volume":"71","journal-title":"J Am Geriatr Soc."},{"key":"ref5","first-page":"e596","article-title":"ACC\/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines.","volume":"140","year":"2019","journal-title":"Circulation."},{"key":"ref6","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1161\/CIR.0b013e318235eb4d","article-title":"AHA\/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation.","volume":"124","year":"2011","journal-title":"Circulation."},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1056\/NEJMoa1800722","article-title":"Effect of aspirin on disability-free survival in the healthy elderly.","volume":"379","year":"2018","journal-title":"N Engl J Med."},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1056\/NEJMoa1800722","article-title":"Effect of aspirin on disability-free survival in the healthy elderly.","volume":"379","year":"2018","journal-title":"N Engl J Med."},{"key":"ref9","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1136\/gutjnl-2020-321585","article-title":"Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial.","volume":"70","year":"2021","journal-title":"Gut."},{"key":"ref10","first-page":"169","article-title":"The role of proton pump inhibitors in the management of upper gastrointestinal disorders.","volume":"14","year":"2018","journal-title":"Gastroenterol Hepatol."},{"key":"ref11","first-page":"928","article-title":"Effect of proton pump inhibitors on risks of upper and lower gastrointestinal bleeding among users of low-dose aspirin: a population-based observational study.","year":"2020","journal-title":"J Clin Med."},{"key":"ref12","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.jacc.2023.04.003","article-title":"AHA\/ACC\/ACCP\/ASPC\/NLA\/PCNA guideline for the management of patients with chronic coronary disease.","volume":"82","year":"2023","journal-title":"JACC."},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1097\/ACM.0000000000002750","article-title":"SQUIRE-EDU (Standards for Quality Improvement Reporting Excellence in Education): publication guidelines for educational improvement.","volume":"94","year":"2019","journal-title":"Acad Med."},{"key":"ref14","article-title":"Aspirin use for primary prevention in older adults.","year":"2023","journal-title":"J Am Geriatr Soc."},{"key":"ref15","first-page":"106504","article-title":"Aspirin prescribing for cardiovascular disease in middle-aged and older adults in Ireland: findings from the Irish Longitudinal Study on Ageing.","volume":"147","year":"2023","journal-title":"Prev Med."},{"key":"ref16","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1007\/s10620-008-0556-8","article-title":"An estimate of hospitalization cost for elderly patients with acute upper gastrointestinal bleeding in the USA.","volume":"54","year":"2009","journal-title":"Dig Dis Sci."},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.amjmed.2023.08.010","article-title":"Trends in upper gastrointestinal bleeding in patients on primary prevention aspirin: a nationwide emergency department sample analysis, 2016-2020.","volume":"136","year":"2023","journal-title":"Am J Med."}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2024\/00000039\/00000006\/art00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T04:32:50Z","timestamp":1717216370000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2024.218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,1]]}},"alternative-id":["2639-9636(20240601)39:6L.218;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2024.218","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,1]]}}}