A pragmatic randomized trial of a polypill-based strategy to improve use of indicated preventive treatments in people at high cardiovascular disease risk

Anushka Patel, Alan Cass, David Peiris, Timothy Usherwood, Alex Brown, Stephen Jan, Bruce Neal, Graham Hillis, Natasha Rafter, Andrew Maxwell Tonkin, Ruth Webster, Laurent Billot, Severine Bompoint, Carol Burch, Hugh Burke, Noel Hayman, Barbara Molanus, Christopher Michael Reid, Louise Mary Shiel, Samantha TogniAnthony Rodgers

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80 Citations (Scopus)

Abstract

Background: Most individuals at high cardiovascular disease (CVD) risk worldwide do not receive any or optimal preventive drugs. We aimed to determine whether fixed dose combinations of generic drugs (`polypills?) would promote use of such medications. Methods: We conducted a randomized, open-label trial involving 623 participants from Australian general practices. Participants had established CVD or an estimated five-year CVD risk of 15 , with indications for antiplatelet, statin and 2 blood pressure lowering drugs (`combination treatment?). Participants randomized to the `polypill-based strategy? received a polypill containing aspirin 75 mg, simvastatin 40 mg, lisinopril 10 mg and either atenolol 50 mg or hydrochlorothiazide 12.5 mg. Participants randomized to `usual care? continued with separate medications and doses as prescribed by their doctor. Primary outcomes were self-reported combination treatment use, systolic blood pressure and total cholesterol. Results: After a median of 18 months, the polypill-based strategy was associated with greater use of combination treatment (70 vs. 47 ; relative risk 1.49, (95 confidence interval (CI) 1.30 to 1.72) p
Original languageEnglish
Pages (from-to)920 - 930
Number of pages11
JournalEuropean Journal of Preventive Cardiology
Volume22
Issue number7
DOIs
Publication statusPublished - 2015

Cite this

Patel, A., Cass, A., Peiris, D., Usherwood, T., Brown, A., Jan, S., Neal, B., Hillis, G., Rafter, N., Tonkin, A. M., Webster, R., Billot, L., Bompoint, S., Burch, C., Burke, H., Hayman, N., Molanus, B., Reid, C. M., Shiel, L. M., ... Rodgers, A. (2015). A pragmatic randomized trial of a polypill-based strategy to improve use of indicated preventive treatments in people at high cardiovascular disease risk. European Journal of Preventive Cardiology, 22(7), 920 - 930. https://doi.org/10.1177/2047487314530382