A study of the use of aspirin in the secondary prevention of myocardial infarction in Trinidad and Tobago

ABSTRACT

OBJECTIVE: To determine the knowledge, attitude to and practice of aspirin prescribing by physicians, dispensing by pharmacies and usage by patients in the secondary prevention of myocardial infarction (MI) during the period September 1998 to August 1999. DESIGN AND METHODS: 119 doctors registered with the Trinidad and Tobago Medical Association were administered a questionnaire via a telephone interview on their prescription of aspirin in the secondary prevention of MI. Ninety-four registered pharmacies were administered a similar questionnaire to assess availability of aspirin. Seventy-three patients attending the San Fernando General Hospital (SFGH) and 82 patients from the Eric Williams Medical Sciences Complex (EWMSC) Cardiology clinic with a history of MI were each administered a questionnaire on their use of aspirin. RESULTS: Forty-three doctors (36.1 percent, 95 percent CI 27.5-45.4) prescribed the recommended dose of 75-100 mg of aspirin for the secondary prevention of MI. Of the 82 patients interviewed from EMSC, 28 (34.2 percent) were taking the recommended dose, as compared with 11 (15.19 percent) patients from SFGH. Throughout Trinidad and Tobago, only 51 pharmacies (54.3 percent, 95 percent CI 43.7-64.6) stocked the required dose. CONCLUSIONS: The prescribing habits, availability and use of the recommended dose of aspirin in the secondary prevention of MI are unacceptable and clearly indicate an urgent need to improve the management of MI.(Au)