Patient Preferences for a Polypill for the Prevention of Cardiovascular Diseases

Tracey-Lea Laba; Kirsten Howard; John Rose; David Peiris; Julie Redfern; Tim Usherwood; Alan Cass; Anushka Patel; Stephen Jan

doi:10.1177/1060028015570468

Patient Preferences for a Polypill for the Prevention of Cardiovascular Diseases

Tracey-Lea Laba, Kirsten Howard, John Rose, David Peiris, Julie Redfern, Tim Usherwood, Alan Cass, Anushka Patel, Stephen Jan

Wellbeing and Preventable Chronic Disease

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Polypill-based strategies have improved patient use of preventive cardiovascular disease (CVD) medications in clinical trials. Continued use in real-world settings relies on patients preferring a polypill over current treatment. Objective: Within a clinical trial assessing a CVD polypill-based strategy on patient adherence (Kanyini Guidelines Adherence with the Polypill study [Kanyini GAP]), we used discrete choice experiment (DCE) to assess the influence of polypill-based treatment attributes and patient characteristics on preferences for CVD preventive treatment.

Methods: A DCE survey was administered to Kanyini GAP participants, involving choices between 2 hypothetical treatment options and no treatment for CVD prevention. Attributes delineating a polypill from current treatment were assessed: out-of-pocket costs, tablet number, administration, and prescriber visit frequency. The odds ratios (ORs) for preferring treatment, trade-off between treatment-related attributes, and willingness to pay against other attributes were estimated.

Results: In all, 332 of 487 (68%) participants completed the survey. Active treatment, compared with no treatment, was chosen by 93%. Treatment preference decreased with increasing out-of-pocket cost (OR = 0.04; 95% CI = 0.03-0.05) and tablet number (OR = 0.69; 95% CI = 0.59-0.81). Out-of-pocket cost was the most important attribute. Respondents were willing to pay $3.45 per month for each tablet reduction. Education and household income significantly influenced treatment preference.

Conclusions: Assuming equivalent efficacy and safety of treatment options, the treatment-specific attributes that were assessed and influenced patient preference strongly accord with the posited advantages of the cardiovascular polypill. The study provides promising evidence that improvements in treatment adherence observed in CVD polypill trials may translate to the real world and potentially close treatment gaps in CVD prevention.

Original language	English
Pages (from-to)	528-539
Number of pages	12
Journal	Annals of Pharmacotherapy
Volume	49
Issue number	5
DOIs	https://doi.org/10.1177/1060028015570468
Publication status	Published - 1 May 2015

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@article{1ce18880e4eb4ddbbc380d87367aa9bd,

title = "Patient Preferences for a Polypill for the Prevention of Cardiovascular Diseases",

abstract = "Background: Polypill-based strategies have improved patient use of preventive cardiovascular disease (CVD) medications in clinical trials. Continued use in real-world settings relies on patients preferring a polypill over current treatment. Objective: Within a clinical trial assessing a CVD polypill-based strategy on patient adherence (Kanyini Guidelines Adherence with the Polypill study [Kanyini GAP]), we used discrete choice experiment (DCE) to assess the influence of polypill-based treatment attributes and patient characteristics on preferences for CVD preventive treatment. Methods: A DCE survey was administered to Kanyini GAP participants, involving choices between 2 hypothetical treatment options and no treatment for CVD prevention. Attributes delineating a polypill from current treatment were assessed: out-of-pocket costs, tablet number, administration, and prescriber visit frequency. The odds ratios (ORs) for preferring treatment, trade-off between treatment-related attributes, and willingness to pay against other attributes were estimated. Results: In all, 332 of 487 (68%) participants completed the survey. Active treatment, compared with no treatment, was chosen by 93%. Treatment preference decreased with increasing out-of-pocket cost (OR = 0.04; 95% CI = 0.03-0.05) and tablet number (OR = 0.69; 95% CI = 0.59-0.81). Out-of-pocket cost was the most important attribute. Respondents were willing to pay $3.45 per month for each tablet reduction. Education and household income significantly influenced treatment preference. Conclusions: Assuming equivalent efficacy and safety of treatment options, the treatment-specific attributes that were assessed and influenced patient preference strongly accord with the posited advantages of the cardiovascular polypill. The study provides promising evidence that improvements in treatment adherence observed in CVD polypill trials may translate to the real world and potentially close treatment gaps in CVD prevention. ",

keywords = "acetylsalicylic acid, blood pressure lowering agent, cardiovascular agent, hydroxymethylglutaryl coenzyme A reductase inhibitor, unclassified drug, drug combination, aged, Article, body weight, cardiovascular disease, cardiovascular risk, controlled study, drug cost, drug efficacy, female, human, lowest income group, major clinical study, male, medication compliance, patient preference, pill, polypill, priority journal, tablet, Cardiovascular Diseases, economics, health care cost, information processing, middle aged, practice guideline, statistical model, Aged, Cardiovascular Agents, Data Collection, Drug Combinations, Female, Guideline Adherence, Health Expenditures, Humans, Male, Medication Adherence, Middle Aged, Models, Econometric, Patient Preference",

author = "Tracey-Lea Laba and Kirsten Howard and John Rose and David Peiris and Julie Redfern and Tim Usherwood and Alan Cass and Anushka Patel and Stephen Jan",

note = "National Health and Medical Research Council (NHMRC) of Australia (App: 1004623)",

year = "2015",

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doi = "10.1177/1060028015570468",

language = "English",

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journal = "Annals of Pharmacotherapy",

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T1 - Patient Preferences for a Polypill for the Prevention of Cardiovascular Diseases

AU - Laba, Tracey-Lea

AU - Howard, Kirsten

AU - Rose, John

AU - Peiris, David

AU - Redfern, Julie

AU - Usherwood, Tim

AU - Cass, Alan

AU - Patel, Anushka

AU - Jan, Stephen

N1 - National Health and Medical Research Council (NHMRC) of Australia (App: 1004623)

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: Polypill-based strategies have improved patient use of preventive cardiovascular disease (CVD) medications in clinical trials. Continued use in real-world settings relies on patients preferring a polypill over current treatment. Objective: Within a clinical trial assessing a CVD polypill-based strategy on patient adherence (Kanyini Guidelines Adherence with the Polypill study [Kanyini GAP]), we used discrete choice experiment (DCE) to assess the influence of polypill-based treatment attributes and patient characteristics on preferences for CVD preventive treatment. Methods: A DCE survey was administered to Kanyini GAP participants, involving choices between 2 hypothetical treatment options and no treatment for CVD prevention. Attributes delineating a polypill from current treatment were assessed: out-of-pocket costs, tablet number, administration, and prescriber visit frequency. The odds ratios (ORs) for preferring treatment, trade-off between treatment-related attributes, and willingness to pay against other attributes were estimated. Results: In all, 332 of 487 (68%) participants completed the survey. Active treatment, compared with no treatment, was chosen by 93%. Treatment preference decreased with increasing out-of-pocket cost (OR = 0.04; 95% CI = 0.03-0.05) and tablet number (OR = 0.69; 95% CI = 0.59-0.81). Out-of-pocket cost was the most important attribute. Respondents were willing to pay $3.45 per month for each tablet reduction. Education and household income significantly influenced treatment preference. Conclusions: Assuming equivalent efficacy and safety of treatment options, the treatment-specific attributes that were assessed and influenced patient preference strongly accord with the posited advantages of the cardiovascular polypill. The study provides promising evidence that improvements in treatment adherence observed in CVD polypill trials may translate to the real world and potentially close treatment gaps in CVD prevention.

AB - Background: Polypill-based strategies have improved patient use of preventive cardiovascular disease (CVD) medications in clinical trials. Continued use in real-world settings relies on patients preferring a polypill over current treatment. Objective: Within a clinical trial assessing a CVD polypill-based strategy on patient adherence (Kanyini Guidelines Adherence with the Polypill study [Kanyini GAP]), we used discrete choice experiment (DCE) to assess the influence of polypill-based treatment attributes and patient characteristics on preferences for CVD preventive treatment. Methods: A DCE survey was administered to Kanyini GAP participants, involving choices between 2 hypothetical treatment options and no treatment for CVD prevention. Attributes delineating a polypill from current treatment were assessed: out-of-pocket costs, tablet number, administration, and prescriber visit frequency. The odds ratios (ORs) for preferring treatment, trade-off between treatment-related attributes, and willingness to pay against other attributes were estimated. Results: In all, 332 of 487 (68%) participants completed the survey. Active treatment, compared with no treatment, was chosen by 93%. Treatment preference decreased with increasing out-of-pocket cost (OR = 0.04; 95% CI = 0.03-0.05) and tablet number (OR = 0.69; 95% CI = 0.59-0.81). Out-of-pocket cost was the most important attribute. Respondents were willing to pay $3.45 per month for each tablet reduction. Education and household income significantly influenced treatment preference. Conclusions: Assuming equivalent efficacy and safety of treatment options, the treatment-specific attributes that were assessed and influenced patient preference strongly accord with the posited advantages of the cardiovascular polypill. The study provides promising evidence that improvements in treatment adherence observed in CVD polypill trials may translate to the real world and potentially close treatment gaps in CVD prevention.

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JO - Annals of Pharmacotherapy

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Patient Preferences for a Polypill for the Prevention of Cardiovascular Diseases

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