The polypill to prevent cardiovascular disease

Abstract

The term 'polypill' denotes a single-pill combination of drugs for reducing cardiovascular disease events. The 'polypill strategy' refers to making such a pill available to the population based on age (e.g. 55 years) rather than individually as a result of a clinical decision. This review summarizes recent studies describing physicians' perspectives regarding the polypill. Among 58 physicians in Sri Lanka, 86% likely would prescribe a polypill for primary prevention if a large trial showed it reduced the risk of major cardiovascular disease events. A study of 952 US physicians found that 83% likely would prescribe a polypill for high-risk patients and 62% likely would do so for moderate-risk patients. Among physicians in both countries, degree of risk reduction was an important factor in willingness to prescribe. Other factors considered important were side effects and cost. Physicians had low agreement with forgoing risk factor level monitoring in patients taking a polypill. The majority (89%) of US physicians surveyed would not want a polypill available without a prescription. Current physician acceptance of the polypill seems moderate to high, at least when considering a clinical approach to its use. As trial publications emerge, it is possible that physician perspectives may evolve toward greater acceptance of a population-health approach to the implementation of a polypill.