Aspirin for primary prevention of cardiovascular disease: a review of recent literature and updated guideline recommendations.

INTRODUCTION: Recent clinical trials evaluating the efficacy of aspirin in primary prevention of atherosclerotic cardiovascular disease (ASCVD) have suggested the risk of aspirin may outweigh its benefit in individuals once thought to be candidates for aspirin therapy. These results led to the publication of updated guideline recommendations in 2019 for aspirin use in primary prevention of cardiovascular disease from the American College of Cardiology (ACC) and American Heart Association (AHA). AREAS COVERED: Recent clinical trials and guidelines relevant to aspirin for primary prevention of ASCVD were identified using PubMed® (July 1, 2016 to April 1, 2019). Studies were limited to randomized, controlled clinical trials. The most current clinical practice guidelines were prioritized. EXPERT OPINION: Recent clinical trials demonstrated an increased risk of bleeding associated with aspirin use, which often outweighed cardiovascular risk reduction. In light of this new evidence, the ACC/AHA guidelines recommend aspirin for primary prevention in patients 40-70 years of age at a high ASCVD risk and low bleeding risk, who are unable to optimally control modifiable ASCVD risk factors.

A Co-Curricular Activity to Introduce Pharmacy Students to the Concepts of Innovation and Entrepreneurship.

Objective. To develop, implement, and evaluate a co-curricular activity in which second-year Doctor of Pharmacy (PharmD) students developed an idea for a new clinical pharmacy service. Methods. A brief co-curricular activity based on the television series SharkTank was developed to encourage innovation and entrepreneurship. Second-year pharmacy students worked in assigned teams and were allowed one hour to develop an innovative clinical service to solve a pharmacy-related problem. Students then "pitched" their idea to a panel of four faculty members who served as the "sharks" and graded the teams using a rubric. The rubric which was employed was mapped to the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes. A pre- and post-activity survey was administered to students to gather information about changes in their perceptions of innovation and entrepreneurship in pharmacy. Results. Student groups received higher scores on their ability to present background information and the need for their clinical service and lower scores in areas such as tracking outcomes and predicting challenges. On the post-activity survey, 96.7% of students agreed that the activity gave them a better understanding of pharmacists' roles in establishing new clinical services, and 86.7% stated they intend to actively seek out new clinical pharmacy service opportunities in their future career. Conclusion. Results of the survey demonstrate that students understand the importance of innovation and entrepreneurship in pharmacy practice, and almost all students felt that the activity gave them an even better understanding of the pharmacist's role in clinical service development. This activity can serve as a blueprint for schools of pharmacy looking to incorporate creative and fun methods of exposing PharmD students to innovation and entrepreneurship activities.