{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:31:30Z","timestamp":1782451890124,"version":"3.54.5"},"reference-count":20,"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":"<jats:p><jats:bold>Background<\/jats:bold> Recent cardiovascular guideline updates recommend against the use of aspirin for primary prevention of atherosclerotic cardiovascular disease (ASCVD) in older people. However, aspirin use remains common in this population.  <jats:bold>Objective<\/jats:bold> To implement\n and evaluate the benefit of a pharmacist-driven aspirin deprescribing protocol compared with primary care provider (PCP) education-only in a primary care setting.  <jats:bold>Methods<\/jats:bold> This prospective, cohort project targeted deprescribing for patients prescribed aspirin for primary\n prevention of ASCVD. Patients were included if they received primary care services at the Milwaukee Veterans Health Administration Medical Center (VHA) and were 70 years of age or older. Criteria for exclusion were aspirin obtained outside the VHA system, aspirin prescribed for a non-ASCVD-related\n condition, and\/or a history of ASCVD. Active deprescribing by pharmacists and PCP education took place in the intervention group with PCP education only in the standard-of-care group. The primary outcome was the proportion of patients who had aspirin deprescribed in each group. Secondary outcomes\n included patient acceptability of the intervention and barriers to implementation.  <jats:bold>Results<\/jats:bold> A total of 520 patients were prescribed aspirin in the intervention group versus 417 in the education-only group. Sixty-five patients met intervention criteria and were contacted\n for aspirin deprescribing. The pharmacist-led active deprescribing group led to a higher rate of aspirin deprescriptions versus the education-only group (54% vs 18%; <jats:italic>P<\/jats:italic> = 0.0001) for patients who met criteria.  <jats:bold>Conclusion<\/jats:bold> A pharmacist-led aspirin deprescribing protocol\n within a primary care setting significantly decreased the number of aspirin prescriptions compared with PCP education only.<\/jats:p>","DOI":"10.4140\/tcp.n.2024.228","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T04:30:36Z","timestamp":1716870636000},"page":"228-234","source":"Crossref","is-referenced-by-count":3,"title":["Implementation of a Pharmacist-Driven Aspirin Deprescribing Protocol Among Older Veterans in a Primary Care Setting"],"prefix":"10.4140","volume":"39","author":[{"given":"Christy Johny","family":"Varghese","sequence":"first","affiliation":[{"name":"1 Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Grunske","sequence":"additional","affiliation":[{"name":"2 Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Nagy","sequence":"additional","affiliation":[{"name":"2 Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2625","reference":[{"key":"ref1","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."},{"issue":"1","key":"ref2","first-page":"S125","article-title":"Cardiovascular disease and risk management: standards of medical care in diabetes 2021.","volume":"44","year":"2021","journal-title":"Diabetes Care."},{"issue":"16","key":"ref3","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":"ref4","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1056\/NEJMoa1804988","article-title":"ASCEND Study Collaborative Group. Effects of aspirin for primary prevention in persons with diabetes mellitus.","volume":"379","year":"2018","journal-title":"N Engl J Med."},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1056\/NEJMoa1803955","article-title":"Effect of aspirin on all-cause mortality in the healthy elderly.","volume":"379","year":"2018","journal-title":"N Engl J Med."},{"issue":"10152","key":"ref6","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/S0140-6736(18)31924-X","article-title":"Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomized, double-blind, placebo-controlled trial.","volume":"392","year":"2018","journal-title":"Lancet."},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1001\/jama.2018.20578","article-title":"Association of aspirin use for primary prevention with cardiovascular events and bleeding events: a systematic review and meta-analysis.","volume":"321","year":"2019","journal-title":"JAMA."},{"issue":"16","key":"ref8","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJMoa1805819","article-title":"Effect of aspirin on cardiovascular events and bleeding in the healthy elderly.","volume":"379","year":"2018","journal-title":"N Engl J Med."},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"e2112210","DOI":"10.1001\/jamanetworkopen.2021.12210","article-title":"Use of preventive aspirin among older US adults with and without diabetes.","volume":"4","year":"2021","journal-title":"JAMA Netw Open."},{"issue":"11","key":"ref10","first-page":"573","article-title":"American College of Cardiology and American Heart Association aspirin for primary prevention guideline recommendations for older people.","volume":"36","year":"2019","journal-title":"Sr Care Pharm."},{"issue":"9","key":"ref11","doi-asserted-by":"crossref","first-page":"580","DOI":"10.4140\/TCP.n.2019.580","article-title":"Aspirin use for primary prevention of cardiovascular disease in older adults: a review of clinical guidelines and updated evidence.","volume":"34","year":"2019","journal-title":"Sr Care Pharm."},{"issue":"12","key":"ref12","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1111\/jgs.16243","article-title":"Medication use quality and safety in older adults: 2018 update.","volume":"67","journal-title":"J Am Geriatr Soc."},{"issue":"3","key":"ref13","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/bcp.12975","article-title":"The feasibility and effect of deprescribing in older adults on mortality and health: a systematic review and meta-analysis.","volume":"82","year":"2016","journal-title":"Br J Clin Pharmacol."},{"key":"ref14","article-title":"Patient-Aligned Care Team (PACT).","year":"2024"},{"key":"ref15","article-title":"Clinical Pharmacy Services.","journal-title":"VHA Handbook"},{"key":"ref16","article-title":"Analyze a 2x2 contingency table.","year":"2024"},{"issue":"3","key":"ref17","doi-asserted-by":"crossref","first-page":"e007979","DOI":"10.1161\/CIRCOUTCOMES.121.007979","article-title":"Potential Impact of the 2019 ACC\/AHA guidelines on the primary prevention of cardiovascular disease recommendations on the inappropriate routine use of aspirin and aspirin use without a recommended indication for primary prevention of cardiovascular disease in cardiology practices: insights from the NCDR PINNACLE registry.","volume":"15","journal-title":"Circ Cardiovasc Qual Outcomes."},{"key":"ref18","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.amjcard.2020.09.042","article-title":"Estimating aspirin overuse for primary prevention of atherosclerotic cardiovascular disease (from a nationwide healthcare system).","volume":"137","year":"2020","journal-title":"Am J Cardiol."},{"key":"ref19","first-page":"1","article-title":"Impact of pharmacist intervention to deprescribe inappropriate aspirin therapy in an outpatient anticoagulation clinic at a community hospital.","volume":"17","year":"2022","journal-title":"Am Heart J Plus."},{"key":"ref20","first-page":"S37","article-title":"Evaluation of a pharmacist-driven ambulatory aspirin deprescribing protocol.","volume":"5","year":"2022","journal-title":"Fed Pract."}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2024\/00000039\/00000006\/art00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T04:33:03Z","timestamp":1717216383000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2024.228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,1]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,1]]}},"alternative-id":["2639-9636(20240601)39:6L.228;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2024.228","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6,1]]}}}