https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2024.307667
Abstract
Providing aspirin during pregnancy is a critical intervention proven to reduce the rates of preeclampsia in patients at risk. This quality improvement project prepared family medicine residents to use public health strategies to improve screening of pregnant patients at risk for preeclampsia in an underserved population. A preeclampsia awareness campaign was launched utilizing a publicly available toolkit, while a multidisciplinary team implemented systemic clinical changes to increase the rates of preeclampsia risk factor screening and aspirin prescription to prevent preeclampsia. (Am J Public Health. 2024;114(S4):S318–S321. https://doi.org/10.2105/AJPH.2024.307667)
In 2021, the US Preventive Services Task Force (USPSTF) released updated guidelines on the use of aspirin to prevent preeclampsia.1 Shortly after, the American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine reaffirmed their committee opinion statement on indications for aspirin in pregnancy.2 The use of aspirin in patients with high and moderate risk factors has repeatedly been shown to decrease the incidence of preeclampsia and related adverse outcomes by up to 20%.1 The USPSTF first published guidelines for preeclampsia prevention in 2014; however, these guidelines have been slow to be implemented in practice. Meanwhile, the prevalence of hypertensive disease in pregnancy, including preeclampsia, increased from 10.8% to 13.0% between 2017 and 2019.3 This quality improvement (QI) project focuses on increasing the use of aspirin to prevent preeclampsia in a family medicine resident clinic serving a vulnerable population.