Aspirin Use Among Diabetes Patients in Ethiopia

Cardiovascular disease (CVD) is a major concern for people with diabetes. Those with diabetes are more likely to experience heart problems compared to those without it. This risk is significantly higher, with studies showing that individuals with diabetes can have two to four times more cardiovascular events. The number of people living with diabetes has been growing rapidly. For instance, it jumped from 108 million in 1980 to 425 million in 2017, and predictions suggest it could reach 629 million by 2045.

In particular, people with type 2 diabetes face serious risks. They are two to six times more likely to die from cardiovascular issues compared to those without diabetes. The prevalence of heart disease is much higher among white Americans with type 2 diabetes compared to those without. Complications like coronary heart disease and cardiomyopathy are also rising, indicating that diabetes is closely linked to heart problems. For example, coronary heart disease affects about 5% to 8% of type 2 diabetic patients.

#The Situation in Ethiopia

In Ethiopia, reports indicate that around 1.33 million people are living with diabetes. Various studies have looked at how many diabetes patients also have cardiovascular disease in the country. In one area, nearly 43% of people with type 2 diabetes were found to have cardiovascular issues. In another medical center, about 15% had similar problems.

Researchers are looking into ways to reduce heart problems in those with diabetes. One common approach is using aspirin. Studies show that aspirin can help lower the chances of having severe heart events in high-risk patients. In Primary Prevention trials, aspirin has shown some effectiveness in reducing serious heart problems. However, when it comes to those who have not experienced cardiac events, the benefits of aspirin remain debated.

#Study Overview

This study aims to look at how many diabetes patients in a clinic are using low doses of aspirin and what factors influence this. It took place at a diabetes clinic in Jimma, Ethiopia, from October 1 to November 15, 2020. The clinic serves a large population and treats many diabetes patients.

The researchers included all types of diabetes patients who were regularly visiting the clinic. They excluded anyone who did not agree to participate. They calculated the sample size needed and used a convenient sampling method to gather data.

#Data Collection

To understand the prevalence of aspirin use among diabetes patients, a structured questionnaire was used. It captured demographic information like age, sex, marital status, education level, income, and where the patient lived. It also looked at clinical details such as how long they had diabetes, their history of heart disease, and any medications they were taking.

Before starting data collection, the researchers tested the questionnaire for clarity. They gathered information from both medical records and patient interviews to ensure they had complete data. They also took precautions to protect against COVID-19 during the data collection process.

#Definitions

Certain terms were clearly defined for the study:

• Diabetes mellitus: A chronic condition characterized by high blood sugar levels.
• Primary prevention: Steps taken to prevent the first occurrence of a heart problem.
• Secondary Prevention: Steps taken after a first heart problem to prevent further issues.
• Dyslipidemia: Abnormal levels of fats in the blood.
• Low dose aspirin: Refers to doses between 75-162 mg.

#Data Quality and Analysis

The research team ensured data quality by using standard tools and guidelines for data collection. They trained all staff and checked the information daily for completeness. Data was recorded using software for analysis, and results were summarized in tables.

They used statistics to explore the different factors that could affect aspirin use. Significant variables were further analyzed to see their impact on low-dose aspirin usage.

#Ethical Considerations

The study followed ethical guidelines, obtaining clearance from an ethical review board. Written consent was required from participants, and their privacy was protected throughout the study.

#Results

Out of 403 potential participants, 388 diabetes patients were interviewed, resulting in a response rate of 96.3%. Most participants were in the 50-54 age group, with an average age of about 48. Many were male, and over half lived in rural areas.

In terms of health history, the majority had diabetes for 5-9 years, and nearly half had high blood pressure. A small number had a history of heart attack or stroke.

When looking at aspirin usage, nearly half of the participants (47.2%) reported using low-dose aspirin. The largest group using aspirin was between the ages of 50-64. Most of those taking aspirin also had high blood pressure.

#Aspirin Use in Preventing Heart Problems

Among the diabetes patients, around 21% had a clear reason to use low-dose aspirin. However, even among those who should have been using it, some were not taking it. This shows a gap in either prescription or patient adherence.

A significant number of patients who had indications for aspirin use were not taking it. A common reason given was that they were not prescribed it at all.

#Factors Influencing Aspirin Use

The research showed various factors linked to aspirin use among diabetes patients. Those who had been living with diabetes longer were more likely to use aspirin. Older patients also showed higher usage. Other significant factors included having high blood pressure and high cholesterol levels.

For example, patients who had diabetes for 10-14 years were significantly more likely to use aspirin compared to those with a shorter duration. Age also played a role, with older patients being more likely to take aspirin than younger ones.

#Comparisons with Other Studies

The percentage of diabetes patients using low-dose aspirin in this study was higher than findings from similar studies elsewhere. For instance, the use of aspirin in a US study was about 40.9%. Another study in China found a higher usage of 53.5%.

Additionally, among those who had a history of cardiovascular risk, a notable proportion were on aspirin, with similar results found in other research studies.

#Conclusion

The results indicate that while many diabetes patients are using low-dose aspirin, there are high levels of inappropriate use. A significant number of patients who have indications for aspirin are not using it. This highlights the need for better communication between healthcare providers and patients regarding the importance of aspirin in preventing heart disease.

In summary, future efforts should focus on improving the prescription process for aspirin. Healthcare workers should ensure patients understand why they should take aspirin and how it can help them. Further studies are needed to explore the impact of updated guidelines on aspirin use among diabetes patients and their association with heart disease development.