Assessing patterns of use of cardio-protective polypill component medicines in Australian women.
BACKGROUND
A low-cost 'polypill' could theoretically be one way of improving medication affordability and compliance for secondary prevention of cardiovascular and cerebrovascular disease. The polypill has also been proposed as a primary prevention strategy. Yet many of the issues surrounding the polypill are still being debated and the underlying assumptions have not been proven. In this paper, we step back from the complexities of the debate and report upon the utilization of polypill component medicines in two population cohorts of Australian women who were aged 56-61 years and 81-86 years in 2007.


OBJECTIVE
The aims of this study were firstly, to describe the association between the women's characteristics (health, illness, behavioural, demographic, socioeconomic) and their use of statins and antihypertensive medicines for the treatment of heart disease, and secondly, to discuss possible health and economic benefits for women with these characteristics that may be expected to result from the introduction of a cardio-protective polypill.


METHODS
Survey records from the Australian Longitudinal Study on Women's Health (ALSWH) were linked to 2007 Pharmaceutical Benefits Scheme (PBS) claims for 7,116 mid-aged women and 4,526 older-aged women. Associations between women's characteristics (self-reported in ALSWH surveys) and their use of statins and antihypertensive medicines (measured through PBS claims in 2007) were analysed using Chi-square and multivariate regression techniques.


RESULTS
Between 2002 and 2007, the use of statins in combination with antihypertensives by mid- and older-aged Australian women increased. A moderate yet increasing proportion of mid-aged women were taking statins without antihypertensives, and a high proportion of older-aged women were using antihypertensives without statins. A high proportion of women who were prescribed both statins and antihypertensives were in lower socioeconomic groups and reported difficulty managing on their incomes.


CONCLUSIONS
These results suggest that a polypill may provide an easy-to-take, cheaper alternative for Australian women already taking multiple cardiovascular disease medications, with particular benefits for older women and women in lower socioeconomic groups. Future research is needed to quantify the potential social and economic benefits of the polypill.
Research Centre for Gender, Health and Ageing, HMRI Building, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. jenny.stewartwilliams@newcastle.edu.au
Jennifer A
JA
Stewart Williams
Christopher J
CJ
Wallick
Julie E
JE
Byles
Christopher M
CM
Doran
D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001315:Australia; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004338:Drug Combinations; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D016015:Logistic Models; D008875:Middle Aged; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents; D002316:Cardiotonic Agents; D004338:Drug Combinations; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors