AJP: A Quality Improvement Initiative to Optimize Low-Dose Aspirin Use in Patients with Moderate Risk Factors for Preeclampsia

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Abstract

Objective

This study aimed to increase the rate of low-dose aspirin (LDA) counseling and treatment in patients with two or more moderate risk factors for preeclampsia (PMRF) from 9 to 50% within a 4-month period after implementation of interventions.

Study Design

A single-institution quality improvement initiative aimed at LDA screening and counseling of those with PMRF. Two groups were evaluated: Preintervention (January–April 2022) and postintervention (January–April 2023). This initiative focused on identifying PMRF and monitoring rates of LDA counseling and treatment. Rates were assessed at 2-week intervals and presented on a run chart to visualize trends and measure progress over time. Providers underwent education utilizing preeclampsia (PEC) screening flowsheets and integrated a clinical decision-making (CDM) tool in initial prenatal visit documentation using a smart tool. Patients were provided with educational flyers.

Results

In the preintervention group (n = 126), 8.7% of patients received counseling on PMRF risk factors and LDA use, and 7.9% were treated with LDA. In the postintervention group (n = 112), 52.7% of patients received counseling on PMRF risk factors and LDA use, and 35.7% were treated with LDA. There was an 83.5% increase in the percentage of patients counseled following intervention implementation. A progressive increase was noted in counseling rates within the 18 weeks postintervention.

Conclusion

Integrating PEC screening flowsheets, CDM tools, and patient education flyers effectively enhances LDA counseling for patients with two or more PMRFs, with additional benefits seen in high-risk patients. These interventions offer a replicable model to enhance guideline adherence and reduce PEC risk in vulnerable populations.