Aspirin compliance for cardiovascular disease and colorectal cancer prevention in the uninsured population

Abstract Aspirin is an effective anti-inflammatory and antiplatelet agent as an irreversible inhibitor of cyclooxygenase. In 2016, the U.S. Preventive Services Task Force recommended aspirin for primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in patients aged 50 to 69 with a 10% or greater 10-year CVD risk. Due to the lack of literature describing compliance with these recommendations in the uninsured patient population, we studied the aspirin adherence for CVD and CRC prevention in several free medical clinics. We investigated the records of 8857 uninsured patients who visited nine free medical clinics in the Tampa Bay Area in 2016-2017. Aspirin compliance was assessed for patients with prior myocardial infarction (MI) or coronary artery disease (CAD). 54% (n=1467) of patients met the criteria to take aspirin for primary prevention of CVD and CRC, but just 17% of these patients aged 50-59 were on the medication. 16% percent of patients aged 60-69 were taking aspirin and significantly more men than women were on aspirin (p=0.025). Of the 306 patients who had prior MI or CAD, 50% were on the medication for secondary prevention. Among the uninsured population, there is low compliance with recommendations for aspirin usage to reduce the risk of CVD and CRC. This study demonstrates that further improvements are needed to increase adherence to current guidelines and address barriers uninsured patients may face in maintaining their cardiovascular and colorectal health.