Several medicines have been shown to reduce the incidence of someone having a subsequent heart attack or another stroke after having their first stroke. These include blood pressure lowering and cholesterol lowering medicines (e.g. statins). Despite good evidence that these medicines are worth taking, many stroke survivors do not take them optimally. This research aims to find out if it is better/easier to take these medicines if they are combined in a single pill called a ‘polypill’. We plan a number of studies to determine whether such a ‘polypill’ might be of use in stroke survivors aged 65 or over.
Firstly, we plan to look at data from general practices about existing stroke survivors to determine how big a study we need to do. Next, we will ask stroke survivors, their carers, and doctors and nurses what they think the advantages and disadvantages of using a ‘polypill’ in this way might be. This will help us design a study to test whether a polypill is better at lowering blood pressure and cholesterol than normal care, which involves measuring blood pressure and cholesterol levels in the blood and adjusting the medicines according to these readings. This study will be a ‘randomised controlled trial’ in which stroke survivors who agree to take part will either be switched onto a ‘polypill’ or stay on their usual treatment. Which they receive will be determined by chance.
The study will be carried out in two phases – a pilot phase with a small number of people to test feasibility and then a large study with over 1,000 stroke survivors to give a definitive answer. We will see what impact a ‘polypill’ has on blood pressure and blood cholesterol levels, we will measure whether taking a polypill has any other effects on how people feel and/or behave. We will also look at whether if a polypill was introduced, it would provide good value for money, is it less or more expensive than prescribing medication for blood pressure and cholesterol separately?