Can a polypill protect heart health?
Institute researchers are about to begin an innovative trial to test the idea of a low-cost, combination 'polypill' to prevent cardiovascular disease.
People with previous heart attack, stroke or other vascular diseases are among those at highest risk of having a future cardiovascular event. Despite the availability of a number of simple, safe and effective drugs that reduce this risk, a substantial proportion of patients do not receive ‘indicated’ treatments, and particularly, appropriate combinations of these drugs that would maximize their beneficial effects.
The are many reasons for this ‘evidence-practice gap’, including the complexity, inconvenience and costs of prescribing (by doctors) and taking (by patients) of multiple drugs.
A potential innovative strategy to help this scenario is a ‘polypill’ - a single tablet containing fixed-dose combinations of treatments. This strategy holds considerable promise, but the effectiveness of the polypill in improving adherence to indicated drug treatments and, thus, patient outcomes, needs to be evaluated in clinical trials.
The Guidelines Adherence with the Polypill (GAP) study, funded by the National Health and Medical Research Council, is designed to do just that. The GAP study has been developed by researchers at The George Institute and will involve approximately 1000 patients in 60-100 general practices in NSW and Victoria.
Patients at high risk of a cardiovascular event will be randomised to a polypill-based strategy or usual care. The polypill contains aspirin, two blood pressure lowering drugs and a cholesterol lowering drug. Participants will be evaluated at the end of two years to determine whether the polypill-based strategy has improved adherence to ‘indicated’ drugs, and as a consequence, results in improved blood pressure and cholesterol levels.
The George Institute will commence recruitment towards the end of 2008 or early 2009.