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Patients' and providers' perspectives of a polypill strategy to improve cardiovascular prevention in Australian Primary Health Care

Liu, Hueiming, Massi, Luciana, Laba, Tracey-Lea, Peiris, David, Usherwood, Tim, Patel, Anushka, Cass, Alan, Eades, Anne-Marie, Redfern, Julie, Hayman, Noel, Howard, Kirsten, Brien, Jo-anne and Jan, Stephen (2015). Patients' and providers' perspectives of a polypill strategy to improve cardiovascular prevention in Australian Primary Health Care. Circulation: Cardiovascular Quality and Outcomes,8(3):301-308.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 10
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IRMA ID 75039815xPUB872
Title Patients' and providers' perspectives of a polypill strategy to improve cardiovascular prevention in Australian Primary Health Care
Author Liu, Hueiming
Massi, Luciana
Laba, Tracey-Lea
Peiris, David
Usherwood, Tim
Patel, Anushka
Cass, Alan
Eades, Anne-Marie
Redfern, Julie
Hayman, Noel
Howard, Kirsten
Brien, Jo-anne
Jan, Stephen
Journal Name Circulation: Cardiovascular Quality and Outcomes
Publication Date 2015
Volume Number 8
Issue Number 3
ISSN 1941-7713   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84929903254
Start Page 301
End Page 308
Total Pages 8
Place of Publication United States
Publisher Lippincott Williams & Wilkins
Field of Research MEDICAL AND HEALTH SCIENCES
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
This study explores health provider and patient attitudes toward the use of a cardiovascular polypill as a health service strategy to improve cardiovascular prevention.

Methods and Results
In-depth, semistructured interviews (n=94) were conducted with health providers and patients from Australian general practice, Aboriginal community-controlled and government-run Indigenous Health Services participating in a pragmatic randomized controlled trial evaluating a polypill-based strategy for high-risk primary and secondary cardiovascular disease prevention. Interview topics included polypill strategy acceptability, factors affecting adherence, and trial implementation. Transcribed interview data were analyzed thematically and interpretively. Polypill patients commented frequently on cost-savings, ease, and convenience of a daily-dosing pill. Most providers considered a polypill strategy to facilitate improved patient medication use. Indigenous Health Services providers and indigenous patients thought the strategy acceptable and beneficial for indigenous patients given the high disease burden. Providers noted the inflexibility of the fixed dose regimen, with dosages sometimes inappropriate for patients with complex management considerations. Future polypill formulations with varied strengths and classes of medications may overcome this barrier. Many providers suggested the polypill strategy, in its current formulations, might be more suited to high-risk primary prevention patients.

Conclusions
The polypill strategy was generally acceptable to patients and providers in cardiovascular prevention. Limitations to provider acceptability of this particular polypill were revealed, as was a perception it might be more suitable for high-risk primary prevention patients, though future combinations could facilitate its use in secondary prevention. Participants suggested a polypill-based strategy as particularly appropriate for lowering the high cardiovascular burden in indigenous populations.

Keywords adherence
qualitative research
DOI http://dx.doi.org/10.1161/CIRCOUTCOMES.115.001483   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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