Cardiology Letters 2020, 29(2):97-101

Polypill in seniors: possible frequency of fixed drug combination according to the SAFIS study

Dúbrava M¹, Németh F², Drobná T³, Gerlich L⁴

¹ Klinika geriatrie LFUK a UN Bratislava

² Oddelenie vnútorného lekárstva a geriatrie, FNsP J. A. Reimana v Prešove

³ Oddelenie geriatrie a dlhodobo chorých, FN Trenčín

Oddelenie dlhodobo chorých NsP Prievidza - Nemocnica Bojnice, Slovenská republika

Aims: Polypharmacy is one of the most typical features of geriatrics. Unreliable drug usage belongs to its risks, among others. One way of reducing this risk is to integrate more drugs into one tablet (polypill). Nowadays this could be done especially in cardiovascular medicine. Real world data from the health care provided in Slovakia, which would reflect the potential for switching from more tabs with one drug towards the polypill in seniors, are almost unknown.

Methods: We used the "Slovak Audit of atrial FIbrillation Study" (SAFIS) data (3 706 patients, average age 80.5 years) and evaluated how frequently patients had the combination of an angiotensin converting enzyme inhibitor (ACEI) or an AT1-receptor for angiotensin II inhibitor (ARB) and a diuretic, an ACEI/ARB and a betablocker (BB), an ACEI/ARB and a statin or at least 3 out of these 4 drug groups at discharge.

Results: The average number of recommended drugs was 9.1 at discharge. A diuretic, BB, statin or ACEI/ ARB was recommended in 68.9, 64.1, 31.9 and 52.4% of patients respectively. Simultaneous treatment with a diuretic and an ACEI/ARB, BB and an ACEI/ARB, statin and an ACEI/ARB was recommended in 37.9, 36.2, and 19.7% patients respectively. The frequency of these co-treatments was typically higher than 40% in 65-79 yrs. old, declining with age moderately, but staying above 20% even in the oldest (90 yrs. and older) for combinations of an ACEI/ARB with a diuretic or a BB. At least 3 drugs from the groups ACEI/ARB, BB, diuretics, statins were recommended in 38.6% of patients.

Conclusion: The potential for the reduction of the number of daily used tablets with their integration in a polypill is really high in seniors.

Keywords: fixed drug combination; polypill; geriatrics; diuretics; angiotensin converting enzyme inhibitors; sartans; beta-blockers; statins

Published: February 1, 2020  Show citation