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Research ArticleOriginal Research

Low-Dose Aspirin Use Among African American Older Adults

Mohsen Bazargan, Cheryl Wisseh, Edward Adinkrah, Shanika Boyce, Ebony O. King and Shervin Assari
The Journal of the American Board of Family Medicine January 2021, 34 (1) 132-143; DOI: https://doi.org/10.3122/jabfm.2021.01.200322
Mohsen Bazargan
From the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA (MB, CW, SA); Department of Family Medicine, David Geffen School of Medicine, University of California–Los Angeles (MB); Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Los Angeles, CA (CW); Department of Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA (EA); Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA (SB); Department of Family Medicine, Kaiser Permanente, Los Angeles, CA (EOK).
PhD
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Cheryl Wisseh
From the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA (MB, CW, SA); Department of Family Medicine, David Geffen School of Medicine, University of California–Los Angeles (MB); Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Los Angeles, CA (CW); Department of Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA (EA); Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA (SB); Department of Family Medicine, Kaiser Permanente, Los Angeles, CA (EOK).
PharmD, MPH, TTS
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Edward Adinkrah
From the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA (MB, CW, SA); Department of Family Medicine, David Geffen School of Medicine, University of California–Los Angeles (MB); Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Los Angeles, CA (CW); Department of Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA (EA); Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA (SB); Department of Family Medicine, Kaiser Permanente, Los Angeles, CA (EOK).
MBChB, BSc
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Shanika Boyce
From the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA (MB, CW, SA); Department of Family Medicine, David Geffen School of Medicine, University of California–Los Angeles (MB); Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Los Angeles, CA (CW); Department of Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA (EA); Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA (SB); Department of Family Medicine, Kaiser Permanente, Los Angeles, CA (EOK).
MD, FAAP, MPH
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Ebony O. King
From the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA (MB, CW, SA); Department of Family Medicine, David Geffen School of Medicine, University of California–Los Angeles (MB); Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Los Angeles, CA (CW); Department of Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA (EA); Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA (SB); Department of Family Medicine, Kaiser Permanente, Los Angeles, CA (EOK).
MD
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Shervin Assari
From the Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA (MB, CW, SA); Department of Family Medicine, David Geffen School of Medicine, University of California–Los Angeles (MB); Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Los Angeles, CA (CW); Department of Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA (EA); Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA (SB); Department of Family Medicine, Kaiser Permanente, Los Angeles, CA (EOK).
MD, MPH
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Article Figures & Data

Tables

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    Table 1.

    Descriptive Characteristics (n = 683)

    n%
    Gender
     Female43964.3
     Male24435.7
    Age, years
     55 to 6410615.5
     65 to 7433749.3
     ≥ 7524035.1
    Education
     No high school diploma16824.6
     High school diploma24235.4
     Some college or college degree27340.0
    Living alone
     No27640.4
     Yes40759.6
    Smoking behaviors
     Current smoker14220.8
     Past smoker21431.4
     Never smoked32647.8
    Mean ± SD
    Age (years: 55 to 96)71.8 ± 8.3
    Education attainment (1 to 16)12.8 ± 2.2
    Financial strains (1 to 5)1.8 ± 1.1
    Continuity of care (0 to 3)2.5 ± 0.66
    Major chronic conditions (1 to 6)1.8 ± 0.9
    • View popup
    Table 2.

    Low-Dose Aspirin Use and Drug-Aspirin Interactions (n = 683)

    n%Valid %
    Low-dose aspirin use
     No42962.862.8
     Yes25437.237.2
    Prescribed versus self-prescribed aspirin use
     OTC15222.359.8
     Rx10214.940.2
     No low-dose aspirin used42962.8
    Top 5 potentially major aspirin-drug interactions
     Hydrochlorothiazide8333.7
     Metformin5822.8
     Furosemide4915.7
     Glipizide3212.6
     Hydrochlorothiazide + triamterene259.8
    Potential major aspirin-drug interactions (among non-aspirin users)
     No interaction14634.134.1
     One major interaction16137.637.6
     Two major interactions8118.918.9
     Three or more major interactions409.39.3
    Mean ± SD
    Frequency of potentially major aspirin-drug interaction for aspirin users1.3 ± 1.08
    Frequency of potentially major aspirin-drug interactions for non-aspirin users1.1 ± 1.06
    • OTC, over-the counter.

    • View popup
    Table 3.

    Prevalence of Low-Dosage Aspirin and Bivariate Correlations

    Aspirin UsedPClinician PrescribedSelf PrescribedP
    No, n (%)Yes, n%n (%)n (%)
    Gender 
     Male165 (68)79 (32).05234 (43)45 (57).507
     Female264 (60)175 (40)68 (39)108 (61)
    Age, years  .03  .0001
     55 to 64 (young-old)78 (74)28 (26)24 (86)4 (14)
     65 to 74 (mid-old)210 (62)127 (38)50 (39)77 (61)
     ≥ 75 (old-old)141 (59)99 (41)28 (28)71 (72)
    Living alone
     No177 (64)99 (36).55733 (33)66 (67).083
     Yes252 (62)155 (38)69 (44)87 (56)
    Education
     No high school diploma105 (63)63 (37).94633 (52)30 (48).054
     High school diploma154 (64)88 (36)34 (39)54 (61)
     Some college170 (62)103 (33)35 (34)69 (66)
    Smoking  .012  .003
     Current smoker102 (72)40 (28)22 (55)18 (45)
     Past smoker138 (65)76 (36)38 (49)39 (51)
     Never smoked188 (58)138 (42)42 (30)96 (70)
    GI conditions
     No302 (64)171 (36).48763 (37)109 (63).081
     Yes127 (61)81 (39)39 (48)42 (52)
    Diabetes mellitus  .005.664
     No296 (67)147 (33)58 (39)90 (61)
     Yes133 (56)105 (44)44 (42)61 (58)
    Heart conditions  .0001.544
     No329 (68)153 (32)64 (42)89 (58)
     Yes100 (50)99 (50)38 (38)62 (62)
    Stroke  .808 .011
     No370 (63)219 (37)82 (37)138 (63)
     Yes59 (64)33 (36)20 (61)13 (39)
     Mean (SD) Mean (SD) 
    Age (years: 55 to 96)71.2 (8.3)72.7 (8.1).01969.5 (7.7)74.8 (7.7).0001
    Education attainment (1 to 16)12.8 (2.0)12.7 (2.5).36812.4 (2.5)12.9 (2.5).126
    Financial strains (1 to 5)1.8 (1.1)1.7 (1.0).0662.0 (1.2)1.5 (.8).0001
    Continuity of care (0 to 3)2.5 (0.6)2.5 (0.6).7892.4 (0.7)2.6 (.6).007
    Major chronic conditions (1 to 6)1.7 (1.0)2.0 (0.9).00012.1 (0.9)1.9 (.9).273
    • GI, gastrointestinal; SD, standard deviation.

    • View popup
    Table 4.

    Binary Logistic Regression between Independent Variables and Low-Dose Aspirin Used (n = 683)

    Independent VariablesLow-Aspirin Used Vs No UsedSig.
    OR95% CI
    Gender 0.93-1.890.121
     Male1.32
     Female1
    Age, years  
     55 to 64 (young–old)0.730.41-1.330.306
     65 to 74 (mid-old)0.990.69-1.430.972
     ≥ 75 (old-old)1  
    Living alone   
     No1.120.85-1.680.296
     Yes1  
    Education  
     No high school diploma1.020.66-1.550.956
     High school diploma0.960.66-1.390.946
     Some college1 0.815
    Smoking  
     Current smoker0.690.42-1.120.266
     Past smoker0.790.53-1.170.137
     Never smoked1 0.24
    Continuity of Care (scale: 0 – 3)0.860.66-1.110.239
    Financial Stress (scale: 1 to 5)0.9470.80-1.130.063
    Heart conditions   
     No2.241.55-3.230.001
     Yes1  
    Diabetes Mellitus   
     No1.511.07-2.140.019
     Yes1  
    Stroke   
     No0.850.53-1.400.553
     Yes1  
    GI conditions   
     No0.910.62-1330.616
     Yes1  
    Potentially major aspirin-drug interaction   
     No0.790.70-1.410.959
     Yes1  
    • GI, gastrointestinal; OR, odds ratio; CI, confidence interval; Sig, Sigma.

    • Note: −2 Log Likelihood: 857; Sig: 0.0001; Nagelkerke: 0.080.

    • View popup
    Table 5.

    Multinomial Logistic Regression between Independent Variables and Low-Dose Aspirin Used (Self-Prescribed, Clinician-Prescribed Versus No Use (n = 683)

    Independent VariablesClinician PrescribedSig.Self PrescribedSig.
    OR95% CIOR95% CI
    Gender 0.80-2.120.298  0.197
     Male1.31.340.86-2.07
     Female11 
    Age, years    
     55 to 64 (young–old)1.880.91-3.910.890.170.06-0.520.002
     65 to 74 (mid-old)1.470.85-2.520.1750.810.53-1.240.332
     ≥ 75 (old-old)1  1  
    Living alone      
     No1.570.97-2.540.0681.020.68-1.540.91
     Yes1  1  
    Education      
     No high school diploma1.580.90-2.760.1220.710.41-1.210.208
     High school diploma1.050.61-1.800.8580.890.57-1.390.606
     Some college1  1  
    Smoking      
     Current smoker0.820.42-1.570.5410.640.34-1.210.17
     Past smoker0.970.57-1.660.9080.730.45-1.170.189
     Never smoked1  1  
    Continuity of care (scale: 0 – 3)0.720.51-1.020.2980.970.70-1.350.864
    Financial Stress (scale: 1 to 5)1.040.842-1.300.0630.850.67-1.090.179
    Heart conditions      
     No2.051.23-3.410.0062.411.56-3.730.001
     Yes1  1  
    Diabetes mellitus      
     No1.721.07-2.760.0271.390.92-2.110.122
     Yes1  1  
    Stroke      
     No1.40.77-2.530.2690.550.28-1.060.075
     Yes1  1  
    GI conditions      
     No0.980.58– 1.630.9250.850.53-1.360.497
     Yes1  1  
    Potentially major aspirin-drug interaction      
     No1.260.76-2.100.3711.20.79-1.820.401
     Yes1     
    • OR, odds ratio; CI, confidence interval; Sig, Sigma; GI, gastrointestinal.

    • The reference category is: No low-dose aspirin used; −2 Log Likelihood: 1084; df = 30, χ2 = 09.41, Sig: 0.0001; Nagelkerke: 0.151.

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Low-Dose Aspirin Use Among African American Older Adults
Mohsen Bazargan, Cheryl Wisseh, Edward Adinkrah, Shanika Boyce, Ebony O. King, Shervin Assari
The Journal of the American Board of Family Medicine Jan 2021, 34 (1) 132-143; DOI: 10.3122/jabfm.2021.01.200322

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Low-Dose Aspirin Use Among African American Older Adults
Mohsen Bazargan, Cheryl Wisseh, Edward Adinkrah, Shanika Boyce, Ebony O. King, Shervin Assari
The Journal of the American Board of Family Medicine Jan 2021, 34 (1) 132-143; DOI: 10.3122/jabfm.2021.01.200322
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