Key result
Antiplatelet therapy is underused in diabetes, leaving ~28% of eligible patients untreated.
Why the study?
There is uncertainty about the use of antiplatelet therapy in diabetic patients without large-vessel disease and evidence of under-prescription.
Is antiplatelet therapy appropriately prescribed in diabetic patients attending a specialist clinic?
Observational (n=300)
No
Is antiplatelet therapy appropriately prescribed in diabetic patients attending a specialist clinic?
A significant proportion of diabetic patients with indications for antiplatelet therapy are not prescribed it despite lacking contraindications.
Answers are grounded in this paper and cite their sources.
Highlights persistent under-prescription of indicated antiplatelet therapy in diabetes clinics; leaves open whether targeted audits improve uptake.
BACKGROUND: There are definite indications for antiplatelet therapy in diabetes in the presence of large-vessel disease, but in the absence of large-vessel disease, the evidence is less clear. There is also evidence that antiplatelet therapy is under-prescribed. AIM: To investigate the use of antiplatelet drugs in patients attending a diabetic clinic in a large teaching hospital. DESIGN: Retrospective case-note survey. METHODS: We examined the case-notes of 300 consecutive diabetic patients, to determine whether antiplatelet therapy was being used in appropriate patients, including those with established large-vessel disease, hypertension and nephropathy or microalbuminuria. RESULTS: The patients were of mean +/- SD age 61 +/- 13 years, diabetes duration 10 +/- 8 years, BMI 31.4 +/- 6.7 kg/m(2) and HbA(1c) 8.3 +/- 1.5%; 276 (92%) had type 2 diabetes, and 162 (54%) were male. Antiplatelet drugs were being taken by 157 (52%) who fulfilled the survey standard for treatment; a further 83 (28%) met the survey standard but were not receiving treatment, of whom 48 (16% of the total group) had no valid contraindication. DISCUSSION: A significant minority of diabetic patients are being denied antiplatelet drugs despite good indications.
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Woodward et al. (2007) conducted an observational in Diabetes (n=300). Antiplatelet drugs vs. No antiplatelet drugs was evaluated on Appropriate use of antiplatelet therapy. Antiplatelet drugs were under-prescribed in a diabetic clinic, with 28% of patients meeting the standard for treatment not receiving it, including 16% with no valid contraindication.
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