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Many studies have shown that daily use of acetylsalicylic acid (aspirinä) in low doses is beneficial for treatment and prevention of cardiovascular disease. (1, 2)
In the MONICA Manual (3) there is one question about the use of aspirinä.
| 1. | "Are you taking (in the last two weeks) aspirin tablets
to prevent or treat heart disease?" 1 = Yes, taking tablets for this reason 2 = No, I am not taking aspirin tablets 3 = No, but I am taking tablets for reasons unconnected with heart condition 9 = Insufficient data |
|__| |
The MONICA Manual (3) had additional instructions for Question 1.
Code 1 if yes.
Code 2 if the person is not taking aspirin regularly. Include here persons who had taken
occasional aspirin tablets in the last two weeks.
Code 3 if the person is regularly taking aspirin for other reasons than for heart disease
prevention or treatment.
Code 9 if insufficient information is available to use the other codes.
In the Monitoring Project on Cardiovascular Disease Risk Factors following questions were used for aspirin use (4):
| 1. | Do you ever use aspirin? 1. Yes 2. No |
|__| |
| 2. | If yes, how many tablets/month? | |__||__||__| |
| 3. | Which brand? |
In the MORGEN-project the information about the use of aspirin was collected when all medications used in the past week were recorded (4).
The German Federal Health Survey 1998 collected through a physician interview information on the use of pharmacological agents. These were then grouped into 34 categories depending on their indication (5). The question asked whether, during the past 12 months, medications of a particular drug category were used :
daily, or several times per week, or 1-2 times per week, or less than once a week, or 1-3 times per month, or seldom, or never.
There was no drug category for "aspirin for heart disease".
No information available
In the household adult questionnaire, the following questions about the use of acetylsalicylic acid were asked of subject aged 17 years and over (6):
| 1. | In the past month, have you taken any aspirin, Anacin, Bufferin, Ecotrin,
Ascriptin, or Midol? 1. Yes 2. No 9. Don't know |
|__| |
| 2. | How often did you take aspirin, Anacin, Bufferin, Ecotrin, Ascriptin, or
Midol during the past month? ___ times per day ___ times per week ___ times per month 999 Don't know |
|__||__||__| |
The questionnaire for the Italian OEC project contained the following section about the use of aspirin in the prevention and treatment of cardiac disease.
| 1. | During the past two weeks, have you taken aspirin to prevent
or to treat heart disease? 1. Yes, have taken aspirin for that purpose 2. No, have not taken aspirin 3. No, but have taken aspirin for other purpose (non cardiac disease) 4. Insufficient data |
|__| |
| 2. | What is the name of the aspirin containing medication that you take? | |_____________________| |
| 3. | Do you take it daily? | Yes No |
| 4. | Number of pills per day Number of pills per week |
|__| |__||__| |
WHO MONICA Project
The detailed information about the availability and quality of data on use of acetylsalicylic acid is given in the Quality Assessment of Data on Use of Aspirin in the WHO MONICA Project (7). The most common deviation from the standard MONICA format was omitting the alternative "No, but I am taking tablets for reasons unconnected with heart condition".
No information on retrospective quality assurance was available for Risk factor monitoring in the Netherlands, Risk factor monitoring in Germany, UK National Health Surveys, and NHANES III.
WHO MONICA Project
In the WHO MONICA Project the prevalence of acetylsalicylic acid users among survey respondents is reported (8).
Risk factor monitoring in Germany
The German Federal Health Survey 1998 reported prevalence of medication use by drug categories and ranked them by prevalence for men and women and for the old and new states (5), but no specific drug category refers to aspirin use for heart disease.
No information on the indicators for acetylsalicylic acid use was found for Risk factor monitoring in the Netherlands, UK National Health Surveys, and NHANES III.
If the use of prescription medication is collected by drug name (generic or brand), the drugs can then be grouped retrospectively but would also be available for analysis by individual drug entities.
Studies that focused more broadly on health and had not a narrow interest of cardiovascular disease did not always emphasize the indication for acetylsalicylic acid use or prompt the participant specifically with a question on acetylsalicylic acid use and heart disease.
References
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