Do Polypills Increase Medication Adherence for Post-MI Patients?
the MPR take:
In the first six months following acute myocardial infarction (MI), adherence to evidence-based cardiovascular medications is low – can fixed-dose combinations (FDC) help with secondary prevention and improve drug adherence? In the first randomized trial to evaluate the impact of FDC on adherence in post-MI patients, 695 patients from the cross-sectional FOCUS (Fixed-Dose Combination Drug for Secondary Cardiovascular Prevention) study were assigned to a FDC of aspirin 100mg, simvastatin 40mg, and ramipril 2.5, 5, or 10mg or the three medications administered separately. Adherence, blood pressure, low-density lipoprotein cholesterol, safety, and tolerability were studied over a period of nine months. Compared to those receiving separate medications, the polypill group had improved adherence after nine months (50.8% vs. 41%, respectively) although no treatment difference was seen in mean systolic blood pressure (129.6mmHg vs. 128.6mmHg), mean low-density lipoprotein cholesterol levels (89.9mg/dl vs. 91.7mg/dl), serious adverse events (23 vs. 21), or death (1, 0.3% in each group). Although the treatment differences between the two groups were not significant, patients who are at a greater risk of medication non-adherence may benefit from a polypill following MI for secondary prevention.
Background: Adherence to evidence-based cardiovascular (CV) medications after an acute myocardial infarction (MI) is low after the first 6 months. Objectives: The cross-sectional FOCUS (Fixed-Dose Combination Drug for Secondary Cardiovascular Prevention) study (Phase 1) aimed to elucidate factors that interfere with appropriate adherence to CV medications for secondary prevention after an acute MI.
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