Standardizing Screening for Preeclampsia Risk Factors to Improve Prescribing of Low-Dose Aspirin

Burgess, Adriane; Dalke, Kara; Wheeling, Julia; Clark, Kelley

doi:10.1097/jhq.0000000000000362

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Among limited studies assessing strategies for improving aspirin prescribing practices, implementation of standardized preeclampsia risk screening in the electronic health record has been associated with the most significant improvement [ 16 ]. These tools may help to increase identification of patients with moderate-risk factors for preeclampsia, for whom provision of low-dose aspirin is recommended per professional guidelines.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Missed opportunities in aspirin prescribing for preeclampsia prevention

Singh,

Shuman,

Chiofalo

et al. 2023

BMC Pregnancy Childbirth

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Background Hypertensive disorders of pregnancy, including preeclampsia, are a leading cause of perinatal morbidity and mortality in the United States, particularly among low-income and historically marginalized populations. Evidence suggests low-dose aspirin prophylaxis may help prevent preeclampsia in individuals at increased risk of developing the disease. This study examines associations between preeclampsia risk factors and aspirin prescribing practices among patients receiving prenatal care at a network of federally qualified health centers (FQHC). Methods Researchers conducted retrospective chart reviews (n = 523) of pregnant individuals ages 18–50 who completed two or more prenatal visits at the FQHC between January 1, 2019 and December 31, 2020. Prescription patterns for patients at moderate and high risk for preeclampsia were analyzed using unadjusted and adjusted logistic regression models to identify the patients with the greatest risk of not receiving the recommended prophylactic treatment. Results Of 249 total patients considered at risk for preeclampsia, only 39% received an aspirin prescription. 57.89% of patients with any high-risk factor were appropriately prescribed aspirin, but only 27.27% of patients with two or more moderate-risk factors without high-risk factors received a prescription. Clinicians most frequently prescribed aspirin for patients with a history of preeclampsia and history of hypertension. However, aspirin was prescribed a maximum of 78.79% of the time for patients with a prior history of hypertension. Among moderate-risk factors, patients with advanced maternal age, Black race, or nulliparity were significantly more likely in adjusted models to be prescribed aspirin. Conclusions Despite the documented benefits of aspirin prescribing and support from professional societies, there are still many missed opportunities for aspirin prophylaxis to prevent preeclampsia. Future interventions should focus on identifying patients who qualify for aspirin prophylaxis on the basis of having multiple moderate-risk factors without comorbid high-risk factors.

show abstract

Section: Discussion/conclusionmentioning

confidence: 99%

Missed opportunities in aspirin prescribing for preeclampsia prevention

Singh,

Shuman,

Chiofalo

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Among limited studies assessing strategies for improving aspirin prescribing practices, implementation of standardized preeclampsia risk screening in the electronic health record has been associated with the most signi cant improvement. 14 These tools may help to increase identi cation of patients with moderate risk factors for preeclampsia, for whom provision of low-dose aspirin is recommended per professional guidelines.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Missed Opportunities in Aspirin Prescribing for Preeclampsia Prevention

Singh

Shuman

Chiofalo

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Hypertensive disorders of pregnancy, including preeclampsia, are a leading cause of perinatal morbidity and mortality in the United States, particularly among low-income and historically marginalized populations. Evidence suggests low-dose aspirin prophylaxis may help prevent preeclampsia in individuals at increased risk of developing the disease. This study examines associations between preeclampsia risk factors and aspirin prescribing practices among patients receiving prenatal care at a network of federally qualified health centers (FQHC). Methods Researchers conducted retrospective chart reviews (n = 523) of pregnant individuals ages 18–50 who completed two or more prenatal visits at the FQHC between January 1, 2019 and December 31, 2020. Prescription patterns for patients at moderate and high risk for preeclampsia were analyzed using unadjusted and adjusted logistic regression models to identify the patients with the greatest risk of not receiving the recommended prophylactic treatment. Results Of 249 total patients considered at risk for preeclampsia, only 39% received an aspirin prescription. 57.89% of patients with any high-risk factor were appropriately prescribed aspirin, but only 27.27% of patients with two or more moderate risk factors without high risk factors received a prescription. Clinicians most frequently prescribed aspirin for patients with a history of preeclampsia and history of hypertension. However, aspirin was prescribed a maximum of 78.79% of the time for patients with a prior history of hypertension. Among moderate risk factors, patients with advanced maternal age, Black race, or nulliparity were significantly more likely in adjusted models to be prescribed aspirin. Conclusions Despite the documented benefits of aspirin prescribing and support from professional societies, there are still many missed opportunities for aspirin prophylaxis to prevent preeclampsia. Future interventions should focus on identifying patients who qualify for aspirin prophylaxis on the basis of having multiple moderate risk factors without comorbid high risk factors.

show abstract

Standardizing Screening for Preeclampsia Risk Factors to Improve Prescribing of Low-Dose Aspirin

Cited by 2 publications

References 17 publications

Missed opportunities in aspirin prescribing for preeclampsia prevention

Missed opportunities in aspirin prescribing for preeclampsia prevention

Missed Opportunities in Aspirin Prescribing for Preeclampsia Prevention

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