那些有心臟病或中風風險的病人可能會服用大量的藥片,有的藥可以降血壓,有的可以控制膽固醇,還有的可以用來預防心臟病。
Henryk Pycz同時身患高血壓和糖尿病,他參加了一項研究,來看看是否可以通過控制所服用藥片的數量來達到更好的療效。
“當你服用含有幾種藥片的藥物時,實際上是服用了五、六甚至七片藥。”
倫敦帝國學院國家心肺研究所的西蒙·托姆博士知道,要病人來管理好這些藥物是不容易的。
“我們知道在預防性藥物的覆蓋面和繼續使用程度上存在很大缺口,尤其在中低收入國家。”
托姆博士負責了一項涉及2000多病人的研究,其中幾乎90%的患者患有中風或心臟病,其他10%很有可能患上這些病。一半的參加者得到名為多效藥丸的複合日常用藥,含有抑制素、血壓藥和另一種很像阿司匹林的用於預防血液阻塞的藥物。其他的參加者被告知繼續服用常規的藥物。托姆博士說結果明顯表明多效藥丸更好。
“在試驗的最後階段,與常規用藥的小組相比,那些服用多效藥丸小組的病人有更多人根據醫囑服藥。”
那些服用多效藥丸的病人在控制血壓和膽固醇方面都有改善,Pycz說自己學到一些東西。
“這次試驗讓我明白,控制自己的用藥很重要。多效藥丸意味著永遠不會出錯,總能服用正確的藥量。”
托姆博士說這項研究有著重大意義,尤其對於那些錯過用藥的病人來說。
“多效藥丸帶來了巨大的公共衛生機會,來彌合用藥不足和有效使用治療性藥物的缺口。”
托姆博士說,這是因為,那些遵照醫囑服藥並得到最大療效的病人最可能在試驗的開始階段就忽略服藥。
這項研究發表在雜誌《美國醫藥協會》上。
WASHINGTON — Many patients who have heart disease or who have suffered a stroke don’t take their medications as regularly as prescribed. One study shows that a number of stroke patients stop taking their pills within three months after having a stroke. A new study in Britain finds that if patients with heart disease can take a single pill instead of several pills, they are more likely to stay on their medication.
Patients at risk for heart attack or stroke may be taking a lot of pills. Some could reduce blood pressure. Other pills could control cholesterol. Still others might be prescribed to prevent a heart attack.
Henryk Pycz, who has both high blood pressure and diabetes, participated in a study to see if he could do better in managing his health by reducing the number of pills he had to take.
"When I was taking the medication consisting of a variety of tablets, I'd have either five, six or seven tablets to take," he said.
Dr. Simon Thom, from the National Heart and Lung Institute at the Imperial College in London, knew it was hard for patients to manage all those medications.
"We know there's a big shortfall in the coverage and continued usage of preventative medication, particularly in lower middle income countries," he said.
Dr. Thom led a study that involved more than 2,000 patients. Almost 90 percent of them had suffered a stroke or had heart disease. The other 10 percent had a high risk of having one. Half of the participants received a combination daily medication known as a polypill that contained statins, blood pressure medication and another drug like aspirin to prevent blood clots. The other participants were told to continue taking their regular medications. Dr. Thom says the results clearly favored the polypill.
“More patients at the end of the trial were taking indicated medications in the form of the fixed dose combination polypill than were in the usual care group,” he said.
The patients who took the polypill had improvements in control of both blood pressure and cholesterol. Pycz said he also learned something.
"It helped me to understand that controlling your medication is important. The polypill meant that I was never out of sync I always had the correct amount of tablets to take,” he said.
Dr. Thom says the study has huge implications, especially for those who skip their medications.
“The polypill has a big public health opportunity to bridge the gap of under usage of indicated and effective therapeutic medication,” he said.
Dr. Thom says that's because those who made the biggest gains in taking in taking their medications as prescribed were the ones who were most likely to skip them at the beginning of the trial.
The study appears in the Journal of the American Medical Association.