Quality statement 2: Use of aspirin

Quality statement

Adults with atrial fibrillation are not prescribed aspirin as monotherapy for stroke prevention.

Rationale

The risks of taking aspirin outweigh any benefits of taking it as monotherapy for stroke prevention in adults with atrial fibrillation. Healthcare professionals should be aware that adults with atrial fibrillation may need to take aspirin for other indications.

Quality measures

Structure

Evidence of local monitoring arrangements to ensure that adults with atrial fibrillation are not prescribed aspirin as monotherapy for stroke prevention.

Data source: Local data collection.

Process

Proportion of adults with atrial fibrillation who are prescribed aspirin as monotherapy for stroke prevention.

Numerator – the number in the denominator who are prescribed aspirin as monotherapy for stroke prevention.

Denominator – the number of adults with atrial fibrillation.

Data source: Local data collection. Data can be collected using the Royal College of Physicians' Sentinel Stroke National Audit Programme (SSNAP), question 2.1.6.

Outcome

Rates of prescribing aspirin.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (primary and secondary care services) monitor prescribing of pharmacological treatment(s) for adults with atrial fibrillation and have protocols in place to ensure that aspirin is not prescribed as monotherapy for stroke prevention.

Healthcare professionals do not prescribe aspirin as monotherapy for stroke prevention for adults with atrial fibrillation.

Commissioners (NHS England area teams and clinical commissioning groups) specify that primary and secondary care services ensure that aspirin is not prescribed as monotherapy for stroke prevention for adults with atrial fibrillation.

What the quality statement means for patients, service users and carers

Adults with atrial fibrillation are not prescribed aspirin on its own for preventing stroke.

Source guidance

Atrial fibrillation (2014) NICE guideline CG180, recommendation 1.5.15 (key priority for implementation)

Definitions of terms used in this quality statement

Aspirin as monotherapy for stroke prevention

Adults with atrial fibrillation might be taking aspirin for a variety of other conditions; if so, this may result in the person taking aspirin (for the other conditions) as well as anticoagulants. If a person chooses not to take anticoagulants, this decision and the reason(s) for it should be documented.

[Atrial fibrillation (NICE guideline CG180), full guideline]