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
From The George Institute for Global Health, University of Sydney (H.L., L.M., T.-L.L., D.P., A.P., A.-M.E., J.R., S.J.); Department of General Practice, Western Clinical School, University of Sydney (T.U.); Menzies School of Health Research, Charles Darwin University (A.C.); Inala Indigenous Health Service; School of Public Health, University of Sydney (N.H., K.H.); and Faculty of Pharmacy, University of Sydney (J.-a.B.).
Circ Cardiovasc Qual Outcomes. 2015 May;8(3):301-8. doi: 10.1161/CIRCOUTCOMES.115.001483. Epub 2015 May 5.
This study explores health provider and patient attitudes toward the use of a cardiovascular polypill as a health service strategy to improve cardiovascular prevention.
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.
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.
URL: http://www.anzctr.org.au.
12608000583347.
本研究探讨医疗服务提供者和患者对使用心血管复方制剂作为改善心血管疾病预防的健康服务策略的态度。
对来自澳大利亚全科医疗、参与一项实用随机对照试验的原住民社区控制及政府运营的原住民健康服务机构的医疗服务提供者和患者进行了深入的半结构化访谈（n = 94），该试验评估一种基于复方制剂的策略用于高危原发性和继发性心血管疾病的预防。访谈主题包括复方制剂策略的可接受性、影响依从性的因素以及试验实施情况。对转录的访谈数据进行了主题分析和解释性分析。服用复方制剂的患者经常提到每日服药的成本节约、简便性和便利性。大多数医疗服务提供者认为复方制剂策略有助于改善患者用药情况。原住民健康服务机构的提供者和原住民患者认为该策略对原住民患者是可接受且有益的，因为他们疾病负担高。提供者指出固定剂量方案缺乏灵活性，对于有复杂管理考量的患者，剂量有时不合适。未来具有不同强度和药物种类的复方制剂配方可能会克服这一障碍。许多提供者建议，就目前的配方而言，复方制剂策略可能更适合高危一级预防患者。
在心血管疾病预防方面，复方制剂策略总体上为患者和医疗服务提供者所接受。揭示了医疗服务提供者对这种特定复方制剂可接受性的局限性，以及一种看法，即它可能更适合高危一级预防患者，不过未来的组合可能会便于其在二级预防中使用。参与者认为基于复方制剂的策略特别适合降低原住民人群高心血管负担。
12608000583347。
