According to a University of Rochester study of a national sample of more than 3,000 patients, a majority of middle-aged men and women eligible to take aspirin to prevent heart attack and stroke do not remember their doctors ever telling them to do so.

According to lead author Kevin A. Fiscella, M.D., M.P.H., professor of Family Medicine at the UR School of Medicine and Dentistry, competing demands, and limited time to properly assess a patient’s eligibility for aspirin may be a few of the reasons to explain the reluctance.

The study found that uncertainty about the benefits of aspirin therapy versus potential harms like bleeding in the digestive track may also hinder physicians’ decisions.

Co-author John Bisognano, M.D., Ph.D., director of outpatient cardiology services at UR Medicine, said most physicians can agree on approaches to medical care in immediately life-threatening situations, but may be less enthusiastic to embrace preventive guidelines, especially when they involve wide-ranging interventions for a large segment of the population.

New studies that present conflicting data may also complicate the issue, and can be confusing for patients, Bisognano added. Despite the U.S. Preventive Services Task Force guidelines for aspirin published in 2009, the FDA declined to approve the same recommendations as recently as last spring.

“Patients often view changes as an illustration that folks in the medical field can’t really make up their minds,” Bisognano said. “Changes can undermine a practitioner’s or patient’s enthusiasm to immediately endorse new guidelines because they wonder if it will change again in 3 years.”

He added, that science and medical practice is fluid, and the only way to move the field forward is to continually understand and look for ways to apply the new data and avoid assumptions of the past.

Dr. Robbins noted that doctors reluctance to recommend baby aspirin may also be applied to Vitamin D.    8/5/14


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