Advancing aspirin utilization: a review of clinical and systems-based interventions.

Underuse of clinical preventive services (CPS) such as low-dose aspirin therapy leads to tens of thousands of preventable deaths per year. The authors examined the current literature related to delivery of CPS and then provided the results to a preventive medicine expert panel who identified best practices to improve aspirin counseling and use. An exploratory literature search was conducted in PubMed using keywords associated with preventive health interventions. The review included articles published between January 2000 and March 2009. More than 200 articles were identified for review, and 35 met inclusion criteria. Interventions that increased patient-provider contact and physician interactive educational programs were most likely to improve delivery of CPS. The expert panel recommended a prevention systems cascade of reinforcing strategies and tools to maximize appropriate aspirin use. This model emphasizes important interrelationships of clinical practice settings and how they affect aspirin use.