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September 07, 2013

Heart Patients More Likely to Take Medication When in Single Pill

by Carol Pearson

Many patients who have heart disease or who have suffered a stroke don’t take their medications as regularly as prescribed. One study shows that a number of stroke patients stop taking their pills within three months after having a stroke. A new study in Britain finds that if patients with heart disease can take a single pill instead of several pills, they are more likely to stay on their medication. 

Patients at risk for heart attack or stroke may be taking a lot of pills. Some could reduce blood pressure. Other pills could control cholesterol. Still others might be prescribed to prevent a heart attack.

Henryk Pycz, who has both high blood pressure and diabetes, participated in a study to see if he could do better in managing his health by reducing the number of pills he had to take.

"When I was taking the medication consisting of a variety of tablets, I'd have either five, six or seven tablets to take," he said.

Dr. Simon Thom, from the National Heart and Lung Institute at the Imperial College in London, knew it was hard for patients to manage all those medications. 

"We know there's a big shortfall in the coverage and continued usage of preventative medication, particularly in lower middle income countries," he said.

Dr. Thom led a study that involved more than 2,000 patients. Almost 90 percent of them had suffered a stroke or had heart disease. The other 10 percent had a high risk of having one. Half of the participants received a combination daily medication known as a polypill that contained statins, blood pressure medication and another drug like aspirin to prevent blood clots. The other participants were told to continue taking their regular medications. Dr. Thom says the results clearly favored the polypill.

“More patients at the end of the trial were taking indicated medications in the form of the fixed dose combination polypill than were in the usual care group,” he said.

The patients who took the polypill had improvements in control of both blood pressure and cholesterol. Pycz said he also learned something.

"It helped me to understand that controlling your medication is important. The polypill meant that I was never out of sync I always had the correct amount of tablets to take,” he said.

Dr. Thom says the study has huge implications, especially for those who skip their medications.

“The polypill has a big public health opportunity to bridge the gap of under usage of indicated and effective therapeutic medication,” he said.

Dr. Thom says that's because those who made the biggest gains in taking in taking their medications as prescribed were the ones who were most likely to skip them at the beginning of the trial.

The study appears in the Journal of the American Medical Association.