Effect of continuation of antiplatelet therapy on survival in patients receiving physician home visits

Background: Little is known about the effects of continued antiplatelet therapy in patients who receive physician home visits. This study aimed to evaluate the association of survival with the continuation of antiplatelet drugs in patients who received physician home visits. Methods: A retrospective cohort study was conducted in a teaching hospital in Toyota, Japan, from April 2015 to October 2018. All patients who received home visits by physicians from the department of Family Medicine of the hospital were included. The primary outcome was the difference in all-cause mortality between patients who were taking antiplatelet drugs and those who were not. The Cox proportional hazards model was applied, adjusted for the patient's demographic features, activities of daily living, comorbidities, and primary disease requiring home care. Results: A total of 815 patients were included, of whom 61 received antiplatelet drugs (n = 42 for aspirin, n = 17 for clopidogrel, and n = 8 for cilostazol) and 772 received no antiplatelet drugs. The mean age of the patients was 78.3 years, 409 (49.1%) were male, and 314 (37.7%) had end-stage cancer. During a median follow-up period of 120 days (interquartile range, 29-364), 54.3% of the patients died. Compared with patients not taking antiplatelet drugs, patients taking antiplatelet drugs had a better outcome (p < 0.01, log-rank test) and a significantly lower hazard ratio (0.34; 95% confidence interval, 0.17-0.65; Cox proportional hazards regression). Conclusions: The continuous prescription of antiplatelet drugs may have beneficial effects on mortality among patients who receive physician home visits.