This measure uses survey data to assess the percentage of women 56 through 79 years and men 46 through 79 years who discussed the risks and benefits of using aspirin with a doctor or other health provider.

The United States Preventive Services Task Force (USPSTF) strongly recommends that clinicians discuss aspirin chemoprevention with adults who are at increased risk (five-year risk greater than or equal to 3 percent) for coronary heart disease (CHD). Discussions with patients should address both the potential benefits and harms of aspirin therapy. The American Diabetes Association (ADA) encourages the use of aspirin therapy (75-162 mg/day) as a primary prevention strategy in patients with type 1 or type 2 diabetes who are at increased cardiovascular risk, including those who are 40 years of age and older or who have additional risk factors (e.g., family history of cardiovascular disease [CVD], hypertension, smoking, dyslipidemia, albuminuria).

In 2004, CHD was an underlying or contributing cause of death for 451,300 people and accounted for 1 of every 5 deaths in the United States. The prevalence of CHD for both sexes in 2005 was nearly 16 million people, or 7.3 percent of the American population. The cost of cardiovascular diseases and stroke in the United States for 2008 was estimated at $448.5 billion, including health expenditures and lost productivity resulting from morbidity and mortality (indirect costs). Evidence shows that age is a strong demographic factor for CHD. It is projected that by 2030, 1 in 5 Americans will be 65 or older. The need for CHD management is essential.

Aspirin treatment has been shown to prevent one cardiovascular event over an average follow-up of 6.4 years. This means that, on average in a 6.4 year time period, the use of aspirin therapy results in a benefit of three cardiovascular events prevented per 1,000 women and four events prevented per 1,000 men. Aspirin has been shown to reduce CHD in patients with peripheral arterial disease, as well.

Aspirin therapy (75-162 mg/day) as a secondary prevention strategy in patients who have diabetes and a history of CVD is also recommended.

Specifications are consistent with current recommendations from USPSTF and ADA.

Aspirin use; cardiovascular disease (CVD)

The number of eligible members who are women 56 through 79 and men 46 through 79 years of age and who responded to the survey (see the related "Denominator Inclusions/Exclusions" field)

The number of members in the denominator who indicated that their doctor or other provider discussed the risks and benefits of aspirin use to prevent heart attack or stroke (see the related "Numerator Inclusions/Exclusions" field)

Unspecified

Unspecified

Men 46 through 79 years of age; women 56 through 79 years of age

The measurement year

Inclusions
The number of eligible* members who are women 56 through 79 and men 46 through 79 years of age and who responded to the survey

*Eligible Population: Men ages 46 through 79 and women ages 56 through 79 as of December 31 of the measurement year who were continuously enrolled during the measurement year (commercial) or for the last six months of the measurement year (Medicaid), and currently enrolled at the time the survey is completed.

Allowable Gap: No more than one gap in enrollment of up to 45 days during the measurement year (commercial). To determine continuous enrollment for a Medicaid beneficiary for whom enrollment is verified monthly, the member may not have more than a 1-month gap in coverage.

Refer to original measure documentation for additional information regarding eligibility and survey questions.

Exclusions
Any response to the following question indicates a cardiovascular disease (CVD) exclusion:

• "Has a doctor ever told you that you have any of the following conditions? Check all that apply."

Exclude any member who selected any response choice: "A heart attack" or "Angina or coronary heart disease" or "A stroke" or "Any kind of diabetes or high blood sugar."

Inclusions
The number of members in the denominator who indicated that their doctor or other provider discussed the risks and benefits of aspirin use to prevent heart attack or stroke

Note: Refer to the original measure documentation for information regarding survey questions.

Exclusions
Unspecified

CAHPS® 4.0H Adult Survey

This measure requires that separate rates be reported for commercial and Medicaid product lines.

Aspirin use and discussion (ASP).

Unspecified

National Committee for Quality Assurance's (NCQA's) Measurement Advisory Panels (MAPs) are composed of clinical and research experts with an understanding of quality performance measurement in the particular clinical content areas.

In order to fulfill National Committee for Quality Assurance's (NCQA's) mission and vision of improving health care quality through measurement, transparency and accountability, all participants in NCQA's expert panels are required to disclose potential conflicts of interest prior to their participation. The goal of this Conflict Policy is to ensure that decisions which impact development of NCQA's products and services are made as objectively as possible, without improper bias or influence.

For commercial and Medicaid members, this measure is collected using the HEDIS (Healthcare Effectiveness Data and Information Set) version of the CAHPS® survey (CAHPS® 4.0H Adult Survey).

CAHPS® 4.0 is sponsored by the Agency for Healthcare Research and Quality (AHRQ).

Unspecified

Unspecified

Please note: This measure has been updated. The National Quality Measures Clearinghouse is working to update this summary.

The individual measure, "Aspirin Use and Discussion (ASP)," is published in "HEDIS® 2012. Healthcare Effectiveness Data & Information Set. Vol. 2, Technical Specifications for Health Plans."

For more information, contact the National Committee for Quality Assurance (NCQA) at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Telephone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org .

This NQMC summary was completed by ECRI Institute on April 30, 2010. This NQMC summary was updated by ECRI Institute on May 25, 2011 and again on November 26, 2012.

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

For detailed specifications regarding the National Committee on Quality Assurance (NCQA) measures, refer to HEDIS Volume 2: Technical Specifications for Health Plans, available from the NCQA Web site at www.ncqa.org .