Improving Aspirin Use in Diabetes: A Cluster Randomized Trial

Many patients with diabetes do not use aspirin to prevent cardiovascular events. Quality improvement initiatives involving both patients and physicians may be more effective than physician-directed approaches alone.

In a large urban primary care internal medicine practice, this study seeks to test if a patient-directed intervention is more effective than computerized clinician reminders alone for improving the appropriate use of aspirin in adults with diabetes.

The study design is a cluster-randomized trial by physician. The frequency of self-reported regular aspirin use will be compared between patients cared for by physicians in the computerized reminder alone group and the computerized reminder plus physician-supervised, nurse practitioner intervention group.

Inclusion criteria

Diabetes mellitus

• Age at least 40 years old
• At least 2 clinic visits in the 18 months prior to the intervention

Exclusion criteria

• Primary care physician declined enrollment