Pharmacists Can Help Patients Manage Aspirin and Warfarin Therapies to Prevent Strokes and Heart Attacks
The position statements are particularly timely in light of a recent University of Cincinnati Medical Center study that found the incidence of stroke in the U.S. may be dramatically higher than previously estimated. According to the new study, approximately 700,000 strokes occur annually. Heart attack, a similarly destructive medical event, continues to be one of the leading causes of death in the U.S.
Research indicates that stroke, a catastrophic but largely preventable consequence of chronic atrial fibrillation, can be thwarted by the routine use of warfarin or aspirin in appropriate patients. Many patients with stroke risk factors, however, do not receive this therapy, possibly because of prescriber concerns about potential side effects like excessive bleeding. The ASHP Therapeutic Position Statement on Antithrombotic Therapy of Chronic Atrial Fibrillation, which appeared in the February 15, 1998, issue of the American Journal of Health-System Pharmacists (AJHP), encourages pharmacists to take an active role in addressing patient and prescriber concerns and to work closely with other health care providers to optimize the use of these therapies.
The ASHP Therapeutic Position Statement on the Use of Aspirin for Prophylaxis of Myocardial Infarction, published in the September 1, 1997, issue of AJHP, reviews clinical research on aspirin's effectiveness in preventing heart attacks when used in conjunction with changes in lifestyle (i.e., smoking cessation) and treatment of other health problems such as hypertension. The position statement helps identify eligible patients who may benefit from therapy. Pharmacists can educate patients undergoing aspirin therapy about appropriate dosages, product selection, and potential adverse effects such as indigestion and gastrointestinal bleeding. The statement notes that patients with liver or kidney disease, peptic ulcers, or aspirin allergies should not undergo aspirin therapy.
ASHP Therapeutic Position Statements are concise documents that respond to therapeutic issues of concern to health care consumers and pharmacists. These documents are developed through the ASHP Commission on Therapeutics, an advisory group that focuses on societal drug use and therapeutic issues.
ASHP is the 30,000-member national professional association that represents pharmacists who practice in hospitals, health maintenance organizations, long-term care facilities, home care, and other components of health care systems. ASHP believes that the mission of pharmacists is to help people make the best use of medications. Assisting pharmacists in fulfilling this mission is ASHP's primary objective.