Volume : 09, Issue : 09, September – 2022

Title:

32.KNOWLEDGE REGARDING BENEFITS AND HAZARDS OF THE USE OF ASPIRIN IN DIABETIC PATIENTS AMONG NURSES

Authors :

Asima Nazir, Sadia Riasat, Tahira Shaheen

Abstract :

Background: Aspirin is called a wonder drug because of its unique pharmacological properties and therapeutic potential. Aim: this study is conducted to gauge the knowledge of nurses in the management of in-patient and out-patient cases of metabolic syndrome and hence the long-term benefits and hazards of aspirin for the prevention in diabetes and macro-vascular disease. Material and Methods: This observational study was conducted using a purpose based convenient sampling in which 100 nurses working in different departments of District Headquarters Hospital Kasur were enrolled during September 2021 to December 2021. A self-structured expert reviewed hand-out was distributed containing 5 close ended questions regarding benefits and hazards of aspirin use respectively in diabetic patients. The response was recorded and analyzed through SPSS 21. Results: The majority of the participants were female (94%), married (78%), Muslim (80%) with a mean age of 27.22 ± 5.58 years. 46% were charge nurses, 72% had attended formal training courses and 60% had an experience of 10 years and above. (Table 1). 86% of the nurses agreed that aspirin use is associated with the reduction in the all-cause mortality and 97% believed that it helps in the primary prevention of acute myocardial infarction. 70% agreed that aspirin prevents from peripheral vascular disease/diabetic foot. 88% believed that long term aspirin use is associated with the potential risk of GI bleeding and 86% were of the opinion that concomitant use of proton pump inhibitors can help reduce the associated risk. 78% viewed aspirin to alter renal functions because of its NSAID (prostaglandin inhibition affect) thus compromising the renal blood flow and hence the glomerular filtration rate. On the contrary, 72% believed that all newly diagnosed diabetic patient should start taking aspirin on their own irrespective of the consultant opinion, 84% feared aspirin can further aggravate the retinopathy and 66% thought it safe to administer aspirin to uncontrolled hypertensive patients having blood pressure > 200/110mmHg. Conclusion: Due to the grey zone between the benefits and hazards of aspirin use in diabetics, the clinical parameters should be reassessed and comprehensive glycemic control HbA1c <7.0, target blood pressure of <130/80 mmHg, body mass index < 25kg/m² and desirable lipid profile should be ensured along with low dose aspirin for the prophylaxis against CV related mortality and morbidity. Above all the nurses involved in the care of such chronic patients should be educated on the basis of latest treatment guidelines with special consideration to the adverse effects.

Cite This Article:

Please cite this article in Asima Nazir et al, Knowledge Regarding Benefits And Hazards Of The Use Of Aspirin In Diabetic Patients Among Nurses., Indo Am. J. P. Sci, 2022; 09(9).

Number of Downloads : 10

References:

1. Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71-86.

2. Antithrombotic Trialists’ (ATT) Collaboration, Baigent C, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009; 373: 1849.

3. Pignone M, et al.; American Diabetes Association; American Heart Association; American College of Cardiology Foundation. Aspirin for primary prevention of cardiovascular events in people with diabetes: a position statement of the American Diabetes Association, a scientific statement of the American Heart Association, and an expert consensus document of the American College of Cardiology Foundation. Diabetes Care 2010; 33 (6):1395–402.

4. Cull CA, et al. Changing aspirin use in patients with type 2 diabetes in the UKPDS. Diabet Med 2004; 21 (12):1368–71.

5. SIGN 116, Management of diabetes, national clinical guideline; p72, 2010. Available at www.sign.ac.uk/pdf/sign116.pdf.

6. NICE clinical guideline for type 2 diabetes CG87 (partial update of CG66); p28, March 2010.
Available at http://guidance.nice.org.uk/CG87/NICE Guidance/pdf/English.

7. Aspirin treatment in diabetes: Diabetes UK guideline, 2009. Available at www.diabetes.org.uk/About_us/Our_Views/Care_recommendations/ Aspirin-treatment-in-diabetes2/.

8. Belch J, et al.; Prevention of Progression of Arterial Disease and Diabetes Study Group; Diabetes
Registry Group; Royal College of Physicians Edinburgh. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337:a1840.

9. Putzer GJ, et al. Prevalence of patients with type 2 diabetes mellitus reaching the American Diabetes Association’s target guidelines in a university primary care setting. South Med J 2004; 97 (2):145–8.

10. Klein L, Gheorghiade M. Management of the patient with diabetes mellitus and myocardial infarction: clinical trials update. Am J Med 2004; 116 (Suppl 5A):47s– 63s.

11. Al-Ansari SA, et al. Short report: suboptimal diabetes care in high-risk diabetic patients attending a specialist retina clinic. Diabet Med 2009; 26(12):1296–300.

12. Ng FH, et al. High incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease. Aliment Pharmacol Ther 2003; 18 (4):443–9.

13. Hsiao FY, et al. A comparison of aspirin and clopidogrel with or without proton pump inhibitors for the secondary prevention of cardiovascular events in patients at high risk for gastrointestinal bleeding. Clin Ther 2009; 31 (9):2038–47.

14. Chan FK, et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding.N Engl J Med 2005; 352 (3):238–44.

15. McColl E, et al. Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess 2001; 5 (31):1–256.

16. Heidrich J, et al. Knowledge and perception of guidelines and secondary prevention of coronary heart disease among general practitioners and internists. Results from a physician survey in Germany. Eur J Cardiovasc Prev Rehabil 2005;12 (6):521–9.