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IMPLEMENTING A CARDIOVASCULAR DISEASE POLYPILL IN AUSTRALIA
Cardiovascular diseases (CVDs) place a significant health and economic burden on health systems globally. Despite large-scale clinical trials demonstrating substantial reductions in CVD-related mortality and morbidity with the use of antiplatelet, blood pressure lowering and cholesterol lowering therapy in patients with established CVD or at high calculated risk of CVD, treatment gaps among this patient group are large and medication non-adherence substantial. Combining multiple classes of low cost generic CVD preventive medications into one fixed dose combination pill (a “polypill”) has been shown in a series of similarly designed pragmatic clinical trials conducted in Australia (Kanyini GAP), New Zealand (IMPACT), India, England, Ireland, and the Netherlands (UMPIRE) to significantly improve adherence, systolic blood pressure and cholesterol in high risk patients when compared with usual care, especially among those undertreated at baseline. Yet implementing this CVD polypill in practice remains largely elusive.
This presentation will use the results of a mixed-methods process evaluation that was conducted alongside the Australian CVD polypill trial to discuss the potential barriers and enablers to implementing this complex intervention in Australian clinical practice.