Globally, non-communicable chronic diseases account for over 60% of disability-adjusted life years, 70% of deaths and more than 80% of years lived with disability. Cardiovascular diseases, including ischemic heart disease and cerebrovascular disease, contribute significantly to this burden. Despite a decline in age-standardized cardiovascular mortality rates worldwide, over 80% of cardiovascular disease deaths occur in low- and middle-income countries, leading to substantial economic losses. In these countries, cardiovascular diseases affect the working-age population more than in high-income countries, with a significant number of cardiovascular deaths occurring between the ages of 30 and 69.
Medicaments such as aspirin, statins, and antihypertensives reduce
cardiovascular events. However, low medication adherence, often due to issues
like availability, affordability, and challenges within the healthcare system,
compromises the effectiveness of these measures. This is a widespread problem
in low- and middle-income countries, necessitating alternative approaches to
address these limitations.
Objective: The study aims to provide an overview of recent
research on the Polypill, a combination of drugs with fixed doses designed to
prevent primary and secondary cardiovascular events. The Polypill is based on
the principle of increasing adherence by reducing the number of daily
medications.
Methods: The latest studies and trials on Polypill treatment for
preventing cardiovascular disease, including observational studies, clinical
trials, and meta-analyses have been reviewed comprehensively. Case reports and
editorials have been excluded. The JBI critical appraisal checklist, which
scores eight items 36 for a quick visual assessment, was used to evaluate the
search results.
Results: According to the WHO Multidimensional Adherence Model,
researchers have found a high rate of patient acceptability for Polypill
therapy compared to monotherapy in developing nations. This acceptability is
associated with better outcomes, no increase of adverse effects if compared
with monotherapy, and a significantly lower mean annual pharmaceutical
expenditure per patient.
Overall, using the Polypill in low- and middle-income countries
increases the number of years patients live and their quality of life compared
to a combination of individual components.
Conclusions: Combining multiple active ingredients in a single
dosage form could be a significant advancement in preventing cardiovascular
conditions. However, thoroughly assessing all factors involved and creating a
well-planned development strategy is crucial to increasing the likelihood of
success. This study emphasizes the dual challenge posed by the global health
burden of cardio- vascular disease and the barriers to effective prevention and
treatment, especially in low—and middle-income countries. Addressing these
challenges could substantially improve public health outcomes and reduce the
economic burden of non-communicable chronic diseases.
Author
(s) Details
Enma V. Páez Espinosa
Department of Clinical Laboratory, School of Medicine, Pontifical Catholic
University of Ecuador, Ecuador and Center for Research on Health in Latin
America (CISeAL), Pontifical Catholic University of Ecuador, Ecuador.
Eugenia Mato Matute
Department of Biochemistry, CIBER-BBN, Grup Endocrinologia-IIB-Sant Pau,
Barcelona, Spain and Networking Research Centre of Bioengineering, Biomaterials
and Nanomedicine (CIBER-BBN), Madrid, Spain.
Delia M. Sosa Guzmán
Department of Clinical Laboratory, School of Medicine, Pontifical Catholic
University of Ecuador, Ecuador.
Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v7/2335
