2025 GEMSSTAR for Emergency Medicine Supplemental Funding Program - $25,000

"Developing a Foundation for a Novel Emergency Department-Based Intervention to Address Inappropriate Aspirin"

Aspirin is one of the most used drugs in the world. Unfortunately, many older adults will consume aspirin without an established indication, a scenario in which risks (i.e., bleeding) likely outweigh benefits (i.e., primary stroke/myocardial infarction prevention). Furthermore, many patients use aspirin in the presence of drug-drug interactions that increase bleeding risk and in the presence of relative contraindications (i.e., history of recurrent falls). Deprescribing - the purposeful discontinuation or dose reduction of potentially inappropriate drugs – of chronic aspirin use should be considered after the manifestation of a bleeding event resulting in an emergency department (ED) visit. Yet, little is known if older adults on chronic aspirin will discuss the possibility of deprescribing with their primary provider/aspirin prescriber after an ED bleeding event. The objective of this proposal is to conduct foundational research, guided by Intervention Mapping Theory (IMT), to inform the development of a novel ED-based deprescribing intervention to address aspirin use among older adults with bleeding. In completing this work with his mentorship team, Dr. Casey will move towards becoming a pioneering emergency medicine physician with expertise in deprescribing.