Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

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

Patel, Anushka, Cass, Alan, Peiris, David, Usherwood, Tim, Brown, Alex, Jan, Stephen, Neal, Bruce, Hillis, Graham S., Rafter, Natasha, Tonkin, Andrew, Webster, Ruth, Billot, Laurent, Bompoint, Severine, Burch, Carol, Burke, Hugh, Hayman, Noel, Molanus, Barbara, Reid, Christopher M., Shiel, Louise, Togni, Samantha J. and Rodgers, Anthony (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.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 2
Google Scholar Search Google Scholar

IRMA ID 11035xPUB74
Title A pragmatic randomized trial of a polypill-based strategy to improve use of indicated preventive treatments in people at high cardiovascular disease risk
Author Patel, Anushka
Cass, Alan
Peiris, David
Usherwood, Tim
Brown, Alex
Jan, Stephen
Neal, Bruce
Hillis, Graham S.
Rafter, Natasha
Tonkin, Andrew
Webster, Ruth
Billot, Laurent
Bompoint, Severine
Burch, Carol
Burke, Hugh
Hayman, Noel
Molanus, Barbara
Reid, Christopher M.
Shiel, Louise
Togni, Samantha J.
Rodgers, Anthony
Journal Name European Journal of Preventive Cardiology
Publication Date 2015
Volume Number 22
Issue Number 7
ISSN 2047-4873   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84930590680
Start Page 920
End Page 930
Total Pages 11
Place of Publication United Kingdom
Publisher Sage Publications Ltd.
HERDC Category C1 - Journal Article (DIISR)
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 < 0.0001; number needed to treat = 4.4 (3.3 to 6.6)) without differences in systolic blood pressure (−1.5 mmHg (95% CI −4.0 to 1.0) p = 0.24) or total cholesterol (0.08 mmol/l (95% CI −0.06 to 0.22) p = 0.26). At study end, 17% and 67% of participants in polypill and usual care groups, respectively, were taking atorvastatin or rosuvastatin.

Conclusion

Provision of a polypill improved self-reported use of indicated preventive treatments. The lack of differences in blood pressure and cholesterol may reflect limited study power, although for cholesterol, improved statin use in the polypill group counter-balanced use of more potent statins with usual care.
DOI http://dx.doi.org/10.1177/2047487314530382   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
Versions
Version Filter Type
Access Statistics: 10 Abstract Views  -  Detailed Statistics
Created: Tue, 26 Jul 2016, 12:43:24 CST