Attitudes to aspirin use in diabetes in clinical practice: a survey of health care professionals from primary and secondary care settings in the UK

Aspirin is recommended for secondary prevention in diabetes and macrovascular disease. However, recommendation for primary prevention in diabetes remains controversial as does the dose of aspirin prescribed. We conducted a survey to ascertain if such controversies are reflected in health care professionals' views on aspirin prescribing in patients with diabetes. The link to an anonymous online survey was circulated via email; the survey consisted of 26 questions covering demographic characteristics and attitudes to aspirin prescription in primary and secondary prevention in patients with diabetes. The rest of this abstract and article mainly focus on the responses for aspirin preferences in primary prevention. In all, 152 responses were obtained, with primary care comprising 63% (doctors and diabetes specialist nurses) and secondary care making up 37% (predominantly diabetes specialists). Attitudes to aspirin use within primary prevention were: 39/103 (38%) would not routinely consider aspirin and 16/121 (13.2%) would consider it in all patients. Specific risk factors associated with diabetes where aspirin would be considered favourably included the following: (a) hypertension – 44/117 (37.6%) in favour; (b) microalbuminuria – 36/115 (31.3%) with doctors 26/60 (43.3%) vs nurses 10/55 (18.2%) (c) smoking history – 33/116 (28.4%) with doctors 22/60 (36.7%) vs nurses 11/56 (19.6%) (d) strong family history of coronary disease – 68/118 (57.6%) (e) high risk of coronary disease – 71/119 (59.7%) and (f) hyperlipidaemia – 42/116 (36.2%). This survey confirmed that the controversy in current aspirin guidance was reflected in a varied response regarding views about aspirin use in patients with diabetes and primary prevention of vascular disease. Further clarification/guidance on the optimum prescription of aspirin in diabetes is required.