"Polypill" to fight cardiovascular disease: Patients before populations

doi:10.1136/bmj.327.7418.807

BMJ 2003;327:807 (4 October), doi:10.1136/bmj.327.7418.807

Letter

"Polypill" to fight cardiovascular disease

Patients before populations

The first 150 words of the full text of this article appear below.

EDITOR—Wald and Law's provocative paper and the accompanyingeditorial on the "Polypill" was disappointing in focusing onlyon the advantage to the population and ignoring the individual'sviews of the benefit he or she would wish to see from takingpreventive drugs.^1
2

The median threshold of absolute risk reduction below whichpatients would not wish to take a preventive drug may be ashigh as 30% over five years. This is far higher than the benefitof the Polypill, which offers a meagre 7% reduction over 10years if started at age 55.³ We and others found this benefitwould be acceptable to only one in 10 healthy people.³ If onlyone in 10 take the Polypill the effect on the population willbe negligible.

It all comes down to accurate numerical presentation and framingof the benefits of drugs to patients. As the patient's treatmentbroker, doctors . . . [Full text of this article]

Peter Trewby, consultant physician

Darlington Memorial Hospital, Darlington DL3 6HX peter.trewby@sdhc-tr.northy.nhs.uk

Catherine Trewby, general practitioner

Clifton Court Medical Practice, Darlington DL1 5JN