Rationalising antiplatelet drugs in palliative care

Follow the principles of medication rationalisation when rationalising antiplatelet drugs in palliative care.

Stop aspirin and other antiplatelet drugs used for primary prevention of cardiovascular or cerebrovascular disease because the risk of bleeding outweighs potential benefitsAscend Study Collaborative Group, 2018Curtin, 2021Lindsay, 2015—see the Cardiovascular guidelines for further information.

Deprescribing is more complex when antiplatelet drugs are used for secondary prevention of cardiovascular or cerebrovascular disease (eg following acute coronary syndrome or ischaemic stroke). Base the decision to continue or stop an antiplatelet drug on an assessment of the expected benefits of preventing cardiovascular events, time since previous event and risk of bleeding, while considering the patient’s life expectancy and their preferences.