OVER PRESCRIPTION OF ASPIRIN

Abstract

Aspirin came and conquered the world of cardiology in a few years. No other
drug can boast of the enthusiasm that has been shown by cardiologists in
adopting a new medicine. Though it was well known to cardiologists for its role in
treating acute rheumatic fever but now it seems to have transcended all
boundaries and is being prescribed to all patients under the care of cardiologists.
As in older days when Digoxin became the 'mark of identification' of all patients
with suspicion of a cardiac disorder, similarly Aspirin is being prescribed by
cardiologists and more so by physicians and general practitioners to patients
with a possibility of having an illness that may even be remotely related to heart.
The drug is being used even in patients afflicted with congenital and rheumatic
heart diseases with no evidence based indication of Aspirin. The drug is being
prescribed to children and old patients without evaluating the real need.

There are a few reports highlighting the underuse and premature discontinuation
of Aspirin in developed and developing countries. This is common among eligible
patients who are at higher risk and are supposed to derive benefit from Aspirin. It
was observed that increased cardiovascular risk profile only partially influenced
aspirin management. It was suggested that more efforts be made to improve
8,9 appropriate Aspirin use in patients with evidence based indications.

Aspirin is like any other drug and it has to be used like a medicine. It has evidence based indications and the use should be
confined to them. Gastro intestinal symptoms and haemorrhage is a real threat and claims a big toll. The drug should be
prescribed in acute coronary syndrome, secondary prevention after a cardiovascular event but in the setting of primary
prevention the use should be limited to those who are at high risk.