Sadeghi Masoumeh, Askari Ali, Bostan Fatemeh, Heidari Afshin, Ghasemi Golsa, Alavi Tabatabaei Ghazaal, Rafiee Hamed, Karimi Raheleh, Roohafza Hamidreza
Cardiac Rehabilitation Research Center, Cardiology Department, Isfahan University of Medical Sciences, Isfahan, Iran.
Cardiac Rehabilitation Research Center, Cardiology Department, Isfahan University of Medical Sciences, Isfahan, Iran; Cardiology Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Curr Probl Cardiol. 2024 Jan;49(1 Pt A):102061. doi: 10.1016/j.cpcardiol.2023.102061. Epub 2023 Aug 26.
Considering the worldwide mortality and morbidity of cardiovascular diseases (CVDs), the necessity of using multiple pills due to the chronicity of this condition, and the importance of medication adherence in these patients, we conducted this systematic review and meta-analysis to assess the polypill effect on adherence in patients with established CVD and at high risk. To accomplish this review, we searched various databases to access grey literature and several electronic databases to find randomized controlled trials (RCTs) assessing polypills compared to individual pills from January 2000 to October 2022. The outcomes were primarily medication adherence, secondarily systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C) serum level, and serious adverse events (SAEs). Ultimately, 2820 studies were detected and narrowed to 8 RCTs based on the eligibility criteria. In this study, involving 7364 patients, there was a significant improvement in medication adherence in the polypill group compared to the individual pills group (Risk Ratio [RR] = 1.29; [95%CI: 1.10; 1.50]). Out of secondary outcomes, SBP was significantly decreased (Mean Difference [MD] = -1.72 mmHg; [95%CI: -2.40; 1.03]), but LDL-C serum level (MD = -0.65 mg/dl; [95%CI: -4.47; 3.16]) and SAE (RR = 1.08; [95%CI: f0.98; 1.20]) did not have a notable difference in polypill compared to individual pills.
鉴于心血管疾病（CVDs）在全球范围内的死亡率和发病率，以及由于该疾病的慢性病程而需要服用多种药物，并且药物依从性对这些患者很重要，我们进行了这项系统评价和荟萃分析，以评估复方制剂对已确诊的CVD高危患者依从性的影响。为完成这项评价，我们检索了多个数据库以获取灰色文献，并检索了几个电子数据库，以查找2000年1月至2022年10月期间评估复方制剂与单一药物相比的随机对照试验（RCTs）。主要结局为药物依从性，次要结局为收缩压（SBP）、低密度脂蛋白胆固醇（LDL-C）血清水平和严重不良事件（SAEs）。最终，共检测到2820项研究，并根据纳入标准将其缩小至8项RCTs。在这项涉及7364名患者的研究中，与单一药物组相比，复方制剂组的药物依从性有显著改善（风险比[RR]=1.29；[95%CI：1.10；1.50]）。在次要结局中，SBP显著降低（平均差[MD]=-1.72 mmHg；[95%CI：-2.40；1.03]），但与单一药物相比，复方制剂的LDL-C血清水平（MD=-0.65 mg/dl；[95%CI：-4.47；3.16]）和SAEs（RR=1.08；[95%CI：0.98；1.20]）没有显著差异。
