Aspirin Deprescribing Interventions for Primary Prevention: A Systematic Review and Proposed Guidance for Deprescribing

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Main Authors: Alison Lobkovich, Hannah Ferrari, Amber Lanae Martirosov, Insaf Mohammad, Helen Berlie, Candice Garwood, Melissa Lipari
Format: Artículo Open Access
Published: Wiley 2026
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author Alison Lobkovich
Hannah Ferrari
Amber Lanae Martirosov
Insaf Mohammad
Helen Berlie
Candice Garwood
Melissa Lipari
author_facet Alison Lobkovich
Hannah Ferrari
Amber Lanae Martirosov
Insaf Mohammad
Helen Berlie
Candice Garwood
Melissa Lipari
Alison Lobkovich
Hannah Ferrari
Amber Lanae Martirosov
Insaf Mohammad
Helen Berlie
Candice Garwood
Melissa Lipari
collection Wiley Open Access
contents Aspirin Deprescribing Interventions for Primary Prevention: A Systematic Review and Proposed Guidance for Deprescribing Alison Lobkovich Hannah Ferrari Amber Lanae Martirosov Insaf Mohammad Helen Berlie Candice Garwood Melissa Lipari Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy ABSTRACT Recent literature indicates that the benefits of aspirin use for primary prevention of atherosclerotic cardiovascular disease (ASCVD) may be equivocal to the risk. This has resulted in several organizations making updates to their clinical practice guidance on appropriate use. Despite this narrower scope, specific guidance on how to deprescribe aspirin in patients already on therapy for primary prevention is lacking. The purpose of this paper is two‐fold: to provide a systematic review of the literature on aspirin deprescribing strategies and propose a practical aspirin deprescribing algorithm when used discordantly with current recommendations for primary prevention. We conducted searches in databases including EMBASE, PubMed, Web of Science, Scopus, and CINAHL from January 2018 to March 2025. One hundred and sixty‐seven studies were screened, and 13 articles were included. The studies utilized a variety of interventions to impact aspirin deprescribing. In each of the studies included, there was at least some type of prompt to trigger deprescribing aspirin. However, a consistent approach was not defined. A multidisciplinary model occurred in half of the studies included, which resulted in the highest reported deprescribing rate of 78%. However, there were limited descriptions of patient‐related outcomes as a result of deprescribing, warranting additional studies. A deprescribing algorithm can assist in guiding aspirin deprescribing for primary prevention of ASCVD while considering patient preferences in an individually tailored approach. 10.1002/phar.70121 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/phar.70121
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spellingShingle Aspirin Deprescribing Interventions for Primary Prevention: A Systematic Review and Proposed Guidance for Deprescribing
Alison Lobkovich
Hannah Ferrari
Amber Lanae Martirosov
Insaf Mohammad
Helen Berlie
Candice Garwood
Melissa Lipari
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Aspirin Deprescribing Interventions for Primary Prevention: A Systematic Review and Proposed Guidance for Deprescribing Alison Lobkovich Hannah Ferrari Amber Lanae Martirosov Insaf Mohammad Helen Berlie Candice Garwood Melissa Lipari Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy ABSTRACT Recent literature indicates that the benefits of aspirin use for primary prevention of atherosclerotic cardiovascular disease (ASCVD) may be equivocal to the risk. This has resulted in several organizations making updates to their clinical practice guidance on appropriate use. Despite this narrower scope, specific guidance on how to deprescribe aspirin in patients already on therapy for primary prevention is lacking. The purpose of this paper is two‐fold: to provide a systematic review of the literature on aspirin deprescribing strategies and propose a practical aspirin deprescribing algorithm when used discordantly with current recommendations for primary prevention. We conducted searches in databases including EMBASE, PubMed, Web of Science, Scopus, and CINAHL from January 2018 to March 2025. One hundred and sixty‐seven studies were screened, and 13 articles were included. The studies utilized a variety of interventions to impact aspirin deprescribing. In each of the studies included, there was at least some type of prompt to trigger deprescribing aspirin. However, a consistent approach was not defined. A multidisciplinary model occurred in half of the studies included, which resulted in the highest reported deprescribing rate of 78%. However, there were limited descriptions of patient‐related outcomes as a result of deprescribing, warranting additional studies. A deprescribing algorithm can assist in guiding aspirin deprescribing for primary prevention of ASCVD while considering patient preferences in an individually tailored approach. 10.1002/phar.70121 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Aspirin Deprescribing Interventions for Primary Prevention: A Systematic Review and Proposed Guidance for Deprescribing
topic Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
url https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/phar.70121