Evaluating patients' satisfaction and preferences with a secondary prevention cardiovascular polypill: the Aurora Study

Abstract

Aim: To evaluate the satisfaction, preferences and adherence of patients in secondary cardiovascular prevention treated with the CNIC cardiovascular polypill compared with patients treated with the separate monocomponents. Methods: Observational, cross-sectional and multicenter study. Satisfaction was evaluated by the Treatment Satisfaction Questionnaire for Medication 9 items, adherence by the Morisky-Green questionnaire and ad-hoc questions were asked regarding patient preferences. Results: Polypill patients reported higher satisfaction than patients treated with the monocomponents (77.3 vs 71.2%, p < 0.0001). 72.8% of patients treated with the monocomponents would prefer to change to the polypill. Patients treated with the polypill had significantly higher adherence than patients treated with the monocomponents (57.7 vs 41.1%) (p = 0.0027). Conclusion: Polypill patients show higher satisfaction and better adherence. Most patients receiving the monocomponents would prefer a polypill regime.

The CNIC-Polypill reduces recurrent major cardiovascular events in real-life secondary prevention patients in Spain: The NEPTUNO study

“…The importance of full adherence to medication (≥80%) in post-MI patients was shown in another claim database study in over 4000 patients in which those patients who were fully adherent to their prescribed secondary prevention medications had significantly better event-free survival, with a 27% risk reduction of MACE [28]. In the second place, the patient's preferences could also be involved, as in a recent study, patients preferred the CNIC-Polypill compared to the same individual drugs, which translates into greater medication adherence rates [29]. Finally, a synergistic effect between the polypill components (ramipril and atorvastatin vs atorvastatin alone) that would increase the beneficial effect on LDLc reduction without increasing the adverse event rate has been suggested [18].…”

Cost-Effectiveness of the CNIC-Polypill Strategy Compared With Separate Monocomponents in Secondary Prevention of Cardiovascular and Cerebrovascular Disease in Portugal: The MERCURY Study

“…The CNIC-Polypill strategy reduces both CV and cerebrovascular recurrent events at a higher cost but within widely accepted affordability thresholds. Furthermore, secondary prevention patients treated with the CNIC-Polypill have shown in previous studies a significantly higher degree of satisfaction and substantially increased medication adherence compared with patients that were treated with the monocomponents separately, 61 which would further improve the potential health benefits already discussed.…”

Polypill in cardiovascular disease prevention: recent advances

“…The most commonly mentioned advantages were the ease and convenience of taking less pills, costsaving benefits, and improved safety from simplifying, and therefore decreasing confusion about, pill regimens. 51…”

“…The wide use of a cardiovascular polypill in the context of public health strategies for either prevention of patients with previous CV events, and for primary prevention of patients with advanced atherosclerosis and high CV risk, is crucial strategy for the optimization of the best proven treatments. 27,34,37,39,46,50,51,69 However, when a clinician decides starting or switching from previous treatment to a CV polypill in order to simplify treatment of patients with hypertension, dyslipidaemia and advanced atherosclerotic disease or established CV event, a common problem is that the doses of the current antihypertensive and statin used by the patient must be adapted to their hypertension grade and LDL-cholesterol level, which may vary widely between different patients showing a similar global CV risk. Actually, this not should be a major problem because the physician may select among multiple versions of the CNIC-polypill with different doses of the BP-lowering and statin components, allowing a greater flexibility of its prescription and use.…”