Effect of the Polypill on Adherence and Prevention of Cardiovascular Diseases in Patients With or at High Risk of Cardiovascular Diseases: A Meta-Analysis of Randomized Controlled Trials.

Abstract

It is important to understand the role of polypills on medication adherence and clinical outcomes in patients with or at high risk of cardiovascular diseases (CVD) to help decision-makers make robust guidelines on using polypills in these people. Therefore, the current meta-analysis was conducted to assess the impact of polypills on medication adherence and clinical outcomes in patients with or at high risk of CVD. The present meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched the electronic databases PubMed, Embase, and the Cochrane Library for randomized control trials (RCTs) from inception to January 1, 2023. The outcomes assessed in the present meta-analysis were adherence to prescribed drugs at the study end, the incidence of cardiovascular events, and change in low-density lipoprotein cholesterol (LDL-C), total cholesterol, and high-density lipoprotein (HDL) from baseline to the study end in mmol/l. A total of six studies were included in the present meta-analysis, with a total sample size of 13139 (6577 in the polypill group and 6562 in the control group). Meta-analysis showed that medication adherence was significantly higher in patients receiving polypills compared to the control group (relative risk (RR): 1.38, 95% confidence interval (CI): 1.22-1.56, p-value: 0.001). The risk of a cardiovascular event was significantly lower in the polypill group (RR: 0.72, 95% CI: 0.63-0.82, p-value: 0.001). No significant differences were found in the changes in LDL-C and total cholesterol between the two groups. This meta-analysis shows a significant impact of polypills on medication adherence. We also found that polypills can reduce the incidence of cardiovascular events in patients with or at high risk of CVD. Our study has also shown that regardless of the history of CVD, polypills play an important role in promoting medication adherence in patients with and without a history of CVD.