Patient Perspectives on a Polypill Strategy for Heart Failure With Reduced Ejection Fraction: A Convergent-Parallel...

Area of Science:

• Cardiology
• Health Services Research
• Implementation Science

Background:

• Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) is underutilized, especially in disadvantaged populations.
• Polypills (combination pills) may enhance GDMT prescribing and patient adherence.
• Understanding patient perspectives on polypill implementation is crucial for effective strategies.

Purpose of the Study:

• To explore patient perspectives on barriers and facilitators to using polypills for HFrEF.
• To assess patient interest and perceived adherence benefits of a polypill approach.

Main Methods:

• A mixed-methods study involving focus groups and surveys with HFrEF patients and caregivers from a randomized controlled trial (POLY-HF).
• Qualitative data analyzed using directed content analysis within a socioecological framework.
• Quantitative data characterized medication burden and polypill preferences.

Main Results:

• Participants reported significant medication burden (58% taking ≥6 medications) and missed doses (50%).
• High interest (88.6%) and belief (83%) in polypills improving adherence were reported.
• Barriers included pill size and content uncertainty; facilitators included reduced pill burden and caregiver support. Cost was a system-level barrier.

Conclusions:

• Polypill strategies are well-accepted by socioeconomically disadvantaged HFrEF patients.
• Findings support further research into polypill implementation to improve GDMT adherence and outcomes.