Improving Adherence using Combination Therapy (IMPACT): design and protocol of a randomised controlled trial in primary care.

Show simple item record Selak, Vanessa en Elley, Carolyn en Crengle, Suzanne en Harwood, Matire en Doughty, Robert en Arroll, Bruce en Bryant, L en Rafter, N en Hoorn, SV en Wadham, A en Wells, Linda en Milne, Richard en Jackson, Rodney en Bramley, D en Rodgers, A en
dc.coverage.spatial United States en 2012-03-21T00:19:35Z en 2011-11 en
dc.identifier.uri en
dc.description.abstract BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death, and principal reason for the large difference in life expectancy between indigenous Māori and the non-indigenous population in New Zealand. CVD guidelines recommend that people who are at high risk or who have had previous CVD should be offered aspirin, blood pressure lowering and lipid lowering therapies. However, prescribing and adherence rates are low and CVD events remain high. AIM: To assess whether a medication strategy using a fixed dose combination pill ('polypill') could improve prescribing and adherence to recommended medications, lower blood pressure and improve lipids compared with current care over 12 months. METHODS: IMProving Adherence using Combination Therapy (IMPACT) is an open-label randomised controlled trial comparing a once-daily polypill containing four preventive medications with usual care. Six hundred participants who have had previous CVD events or are at high risk of CVD will be enrolled, including 300 Māori. Participants are identified, enrolled and prescribed either the polypill or current medications at their usual primary health care practice, with medications (including the polypill) dispensed through local community pharmacies. The polypill contains 75 mg aspirin, 40 mg simvastatin, 10mg lisinopril and either 12.5mg hydrochlorothiazide or 50mg atenolol. Primary outcomes are adherence to guidelines-recommended medications and changes in systolic blood pressure and low density lipoprotein at 12 months. Secondary outcomes include other lipids, medication dispensing, barriers to adherence, CVD and other serious adverse events, quality of life and prescriber acceptability. The trial is registered with the Australian New Zealand Clinical Trial Registry (ACTRN12606000067572). en
dc.language eng en
dc.publisher Elsevier Inc. en
dc.relation.ispartofseries Contemp Clin Trials en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.subject Cardiovascular Agents en
dc.subject Cardiovascular Diseases en
dc.subject Drug Therapy, Combination en
dc.subject Female en
dc.subject Follow-Up Studies en
dc.subject Humans en
dc.subject Lipids en
dc.subject Male en
dc.subject New Zealand en
dc.subject Patient Compliance en
dc.subject Prevalence en
dc.subject Retrospective Studies en
dc.subject Time Factors en
dc.subject Treatment Outcome en
dc.title Improving Adherence using Combination Therapy (IMPACT): design and protocol of a randomised controlled trial in primary care. en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.cct.2011.07.006 en
pubs.issue 6 en
pubs.begin-page 909 en
pubs.volume 32 en
dc.rights.holder Copyright: Elsevier Inc. en
dc.identifier.pmid 21777702 en
pubs.end-page 915 en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 235099 en Medical and Health Sciences en Population Health en Epidemiology & Biostatistics en Gen.Practice& Primary Hlthcare en School of Medicine en Medicine Department en
dc.identifier.eissn 1559-2030 en
dc.identifier.pii S1551-7144(11)00180-7 en
pubs.record-created-at-source-date 2012-02-10 en
pubs.dimensions-id 21777702 en

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