Antiplatelet therapy for primary and secondary prevention in Jordanian patients with diabetes mellitus

Introduction: Guidelines for diabetes treatment recommend the routine use of aspirin in patients with diabetes mellitus (DM) who have cardiovascular disease (CVD), those with at least one CVD risk factor, and for anyone with DM who is>30 years of age or, if contraindicated, an alternative antiplatelet agent. We evaluated the adherence to these recommendations in a subset of diabetic patients in Jordan, and identified physician and patient characteristics associated with the use of antiplatelet therapy. Materials and methods: A cross-sectional observational study conducted in randomly selected outpatient clinics. The study included 199 adult patients with DM who were eligible for antiplatelet prophylaxis. Review of medical charts and direct interviews with patients were performed to obtain information on demographic characteristics of the patients, clinical factors and medication prescription. Bivariate analysis and multivariate logistic regression methods were used to determine what factors were related to antiplatelet drug use. Results: Among diabetic patients eligible for antiplatelet prophylaxis, the prevalence of antiplatelet drug use for primary or secondary prevention was 84%. Factors associated with antiplatelet prophylaxis were male gender (odds ratio, OR 2.97), presence of angina (OR 3.00), history of myocardial infarction (OR 3.75), history of coronary revascularization (OR 3.12), five or more prescription medications (OR 4.61), and physician's specialty other than endocrinology ( OR 4.35). Conclusions: Adherence rates to the international guidelines regarding routine antiplatelet prophylaxis in adults with DM who are eligible for such prophylaxis are suboptimal. Efforts towards increasing these rates of antiplatelet prophylaxis are necessary.