3-in-1 Cardiovascular Polypill Improves Medication Adherence

Patients adhered to a novel polypill containing 3 cardiovascular medications better than if they received the medications separately, a study suggests.

A novel polypill containing aspirin, simvastatin, and ramipril has been shown to increase patient adherence, and has the potential to prevent more patients from having a second heart attack.

A study on the pill, presented at the European Society of Cardiology’s ESC Congress 2014 in Barcelona, Spain, evaluated patient adherence to secondary prevention medication. The pill, named Trinomia, contains 100 mg aspirin, 40 mg simvastatin, and either 2.5, 5, or 10 mg ramipril.

“Patients were more likely to take their medication to prevent a heart attack when it was given as a polypill, rather than as 3 separate pills,” Valentin Fuster, MD, PhD, principal investigator, said in a press release. Dr. Fuster created the pill in partnership with Cento Nacional de Invertigaciones Cardiovasculares Carlos III in Spain and Ferrer Laboratories. “We found 66% of patients in the polypill group took their drugs compared to just 56% of patients in the group assigned to 3 drugs,” Dr. Fuster said.

The first research phase involved a multi-country analysis of 2118 myocardial infarction (MI) patients, to identify factors that determine medication adherence. The researchers found an average baseline adherence level of 45.5%, they said.

Risks associated with nonadherence included younger age, depression, being on a complex medication regimen, poorer health insurance coverage, and lower levels of social support.

The second research phase tested the fixed-dose combination pill to assess both medication adherence and cardiovascular risk factors. It involved 695 participants who were followed for a period of 9 months.

Although the polypill strategy significantly increased self-reported and directly measured adherence for secondary prevention, the research is ongoing. Future assessments will cover differences between treatment arms, safety, and costs.

“Our results suggest that the polypill has the potential to prevent more patients having a second heart attack,” Dr. Fuster said in a press release. “A randomized trial is under development to test whether the improved adherence with the polypill found in FOCUS results in fewer post MI patients having another MI.”