Research Centre for Gender, Health and Ageing, HMRI Building, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
Drugs Aging. 2013 Mar;30(3):193-203. doi: 10.1007/s40266-013-0051-6.
A low-cost 'polypill' could theoretically be one way of improving medication affordability and compliance for secondary prevention of cardiovascular and cerebrovascular disease. The polypill has also been proposed as a primary prevention strategy. Yet many of the issues surrounding the polypill are still being debated and the underlying assumptions have not been proven. In this paper, we step back from the complexities of the debate and report upon the utilization of polypill component medicines in two population cohorts of Australian women who were aged 56-61 years and 81-86 years in 2007.
The aims of this study were firstly, to describe the association between the women's characteristics (health, illness, behavioural, demographic, socioeconomic) and their use of statins and antihypertensive medicines for the treatment of heart disease, and secondly, to discuss possible health and economic benefits for women with these characteristics that may be expected to result from the introduction of a cardio-protective polypill.
Survey records from the Australian Longitudinal Study on Women's Health (ALSWH) were linked to 2007 Pharmaceutical Benefits Scheme (PBS) claims for 7,116 mid-aged women and 4,526 older-aged women. Associations between women's characteristics (self-reported in ALSWH surveys) and their use of statins and antihypertensive medicines (measured through PBS claims in 2007) were analysed using Chi-square and multivariate regression techniques.
Between 2002 and 2007, the use of statins in combination with antihypertensives by mid- and older-aged Australian women increased. A moderate yet increasing proportion of mid-aged women were taking statins without antihypertensives, and a high proportion of older-aged women were using antihypertensives without statins. A high proportion of women who were prescribed both statins and antihypertensives were in lower socioeconomic groups and reported difficulty managing on their incomes.
These results suggest that a polypill may provide an easy-to-take, cheaper alternative for Australian women already taking multiple cardiovascular disease medications, with particular benefits for older women and women in lower socioeconomic groups. Future research is needed to quantify the potential social and economic benefits of the polypill.
低成本的“复方药”理论上可以提高心血管和脑血管疾病二级预防的药物可负担性和依从性。复方药也被提议作为初级预防策略。然而，围绕复方药的许多问题仍在争论之中，其基本假设尚未得到证实。在本文中，我们从辩论的复杂性中退一步，报告了 2007 年在两个澳大利亚女性人群队列中使用复方药成分药物的情况，这两个队列的女性年龄分别为 56-61 岁和 81-86 岁。
本研究的目的首先是描述女性的特征（健康、疾病、行为、人口统计学、社会经济）与她们使用他汀类药物和降压药物治疗心脏病之间的关系，其次是讨论对于具有这些特征的女性，引入心脏保护复方药可能带来的健康和经济效益。
对澳大利亚女性健康纵向研究（ALSWH）的调查记录进行了链接，并与 2007 年药品福利计划（PBS）对 7116 名中年女性和 4526 名老年女性的索赔进行了链接。使用卡方检验和多变量回归技术分析了女性特征（ALSWH 调查中自我报告）与她们在 2007 年使用他汀类药物和降压药物之间的关系。
在 2002 年至 2007 年间，澳大利亚中年和老年女性联合使用他汀类药物和降压药物的比例有所增加。越来越多的中年女性服用他汀类药物但未使用降压药物，而相当多的老年女性使用降压药物但未服用他汀类药物。开处方同时使用他汀类药物和降压药物的女性中，相当一部分来自社会经济地位较低的群体，并且报告称难以维持收入。
这些结果表明，对于已经服用多种心血管疾病药物的澳大利亚女性，复方药可能是一种更容易服用、更便宜的替代药物，对老年女性和社会经济地位较低的女性尤其有益。需要进一步研究来量化复方药的潜在社会效益和经济效益。
