Cardiovascular ‘polypill’ improved medication adherence, hypertension

Until rigorous data illustrate that the polypill improves concrete clinical CVD outcomes, not just adherence, "the precise advantage of this strategy remains largely unproven," said Dr. J. Michael Gaziano.

One drawback to the UMPIRE trial is that patients in the two intervention groups were given the polypill for free at clinic visits, while those in the usual care group had to pay for their medications. The difference in cost may well have influenced rates of adherence, Dr. Gaziano said.

Moreover, even though the entire study population generally had good medication adherence at baseline and "a good understanding of how to obtain their medications, they were left to get them on their own, making it much easier for the intervention group to obtain the medications," Dr. Gaziano said.

Dr. Gaziano is in the division of aging at Brigham and Women’s Hospital and Harvard Medical School, Boston. Dr. Gaziano also is an associate editor of JAMA. He reported no financial conflicts of interest. These remarks were taken from his editorial accompanying Dr. Thom’s report (JAMA 2013;310:910-1 [doi:10.1001/jama.2013.277066]).