02950nas a2200289   4500000000100000008004100001260001700042100001300059700001200072700001700084700001400101700001400115700001200129700001000141700001300151700001300164700001400177700001700191700001800208700001600226245020900242250001500451300001000466490000600476520212700482020005102609       2015                            d  c-456037184511 aBrien J.1 aLaba T.1 aUsherwood T.1 aHoward K.1 aHayman N.1 aCass A.1 aLiu H1 aEades A.1 aMassi L.1 aRedfern J1 aPeiris David1 aPatel Anushka1 aJan Stephen00aPatients' and providers' perspectives of a polypill strategy to improve cardiovascular prevention in Australian primary health care: a qualitative study set within a pragmatic randomized, controlled trial  a2015/05/07  a301-80 v83 a<p>
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. CLINICAL TRIAL REGISTRATION: URL: http://www.anzctr.org.au. ANZCTRN: 12608000583347.
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  a1941-7705 (Electronic)<br/>1941-7713 (Linking)