Will you take this polypill?
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Cardiology
Will you take this polypill?
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We have discussed the polypill on doc2doc before but you may have heard it featured in the media today. It is claimed that the polypill given to everyone over 50 could extend healthy life by 11 years
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Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bc
Cat:OpenClinicalForum:083a12c9-861a-4a42-a5af-ddc3263b34bcDiscussion:340ee69d-3366-44e9-9632-d9e5cf23468a
Forums » Open clinical » Cardiology » Will you take this polypill?
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Will you take this polypill?
posted at 19/7/2012 6:05 PM BST
on bmj.com
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Posts: 875
First: 17/6/2011 Last: 20/5/2013 |
We have discussed the polypill on doc2doc before but you may have heard it featured in the media today. It is claimed that the polypill given to everyone over 50 could extend healthy life by 11 years - do you believe this and would you take it? |
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Re: Will you take this polypill?
posted at 22/7/2012 1:51 PM BST
on bmj.com
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Posts: 22
First: 24/2/2010 Last: 30/11/2012 |
The problems I have with this study: a) 84 participants are not a lot. b) The treatment was tested against placebo, not against the current best available alternative. c) If someone was to get side effects from one of the components, deciding which one was the culprit could be difficult. d) Lack of "real-world" outcomes.
I also agree with Dr McCartney in that pills are not the answer to preventing cardiovascular disease; lowering the risk factors through lifestyle advice seems to be a better way to go, given the obesity crisis. If people were given a pill with a promise that it would help lower the risk of disease, they might even make unhealthier lifestyle choices, believing that the pill would make up for it. |
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Re: Will you take this polypill?
posted at 22/7/2012 3:08 PM BST
on bmj.com
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Posts: 24
First: 14/5/2009 Last: 7/4/2013 |
no, of course not. I will probably never to take that polypill. It is against the ideas of evidence based medicine. We should learn to make better clinical decisions. Simplex sigillum veri; simplicity is the sign of truth: keep it simple. |
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Re: Will you take this polypill?
posted at 30/7/2012 1:16 AM BST
on bmj.com
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Posts: 624
First: 13/4/2011 Last: 15/5/2013 |
Hi sadian: Firstly, thanks for the simple and smart way of posting this issue. The poll was also quite good and I voted for the second option.
I have read the article carefully because I still do not have a definitive (if we can ever say that in Medicine...) opinion about this issue. I like those randomised cross-over designs because they do increase the power for testing the hypothesis. In my humble opinion, the polypill should not be taken only based on age parameters, but based on individual global cardiovascular risk assessments it makes a lot more sense. And we still need a large randomised clinical trial with the polypill. This idea deserves this kind of testing. I would not not take or prescribe this specific one because of hydrochlorothiazide and 40 mg Simvastatin. And you sadian, what is your opinion? All Best, Joey |
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Re: Will you take this polypill?
posted at 30/7/2012 2:23 PM BST
on bmj.com
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Posts: 875
First: 17/6/2011 Last: 20/5/2013 |
Thanks Joey R - I reckon that as with lots of medicine the inverse care law will apply ie the worried well will take it. I personally think that we would be better of dealing with the causes rather than trying to fix the consequences as summerdaisy says. I for one would like to see a large trial comparing the polypill with better lifestyle modification and an exercise programme in those at high risk (say >20% risk over 10 years). sadian |
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Re: Will you take this polypill?
posted at 30/7/2012 5:05 PM BST
on bmj.com
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Posts: 624
First: 13/4/2011 Last: 15/5/2013 |
Hi again sadian I also agree that the so far small studies with the various polypills tend to artificially increase the benefits (third option of your poll). The real world benefits and harms from the polypill could be shown only by large randomised trials. All Best, Joey
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Re: Will you take this polypill?
posted at 8/10/2012 9:17 AM BST
on bmj.com
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Posts: 875
First: 17/6/2011 Last: 20/5/2013 |
You might like to read about the first conference on this subject featured in heart wire. http://www.theheart.org/article/1452321.do?utm_medium=email&utm_source=20121005_TopStories_EN&utm_campaign=newsletter I'm interested to see that the underlying premise that individuals are more likely to adhere to one pill remains to be proven! Sadian |
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Re: Will you take this polypill?
posted at 8/10/2012 12:41 PM BST
on bmj.com
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Posts: 322
First: 12/11/2010 Last: 20/5/2013 |
Too many people are trying to frighten us into believeing that we must take a pill to keep ourselves alive and healthy as long as possible. Two important questions need to be answerd: Who profits? - as more drugs leave patent protection the calls for 'ordinary' people to be able increase. This makes you question whether the motive is health, or profit. Who holds the patent? (As above) |
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Re: Will you take this polypill?
posted at 8/10/2012 2:32 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
There is no prospect in taking or prescribing or even discussing poor evidence based ?polypills. One should rather advice to change the lifestyle, regular exercises, & dietary measures to reduce the cardiovascular risk factors. |
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Re: Will you take this polypill?
posted at 8/10/2012 8:47 PM BST
on bmj.com
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Posts: 1784
First: 7/3/2009 Last: 18/5/2013 |
1. Dietary and lifestyle modifications come first. 2. Family history of cardiovascular disease, hyperlipidemia ,diabetes, thrombotic events might have a say about if lifestyle and dietary modifications suffice of a medication or medications are needed. I am not convinced about one polypill though. Definitely not in the forthcoming era of personalised medicine with all knowledge we accumulate about carrying mutations in different genes and about metabolic polymorphism.
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Forums » Open clinical » Cardiology » Will you take this polypill?
