Participants were purposively selected for interview from nine primary care practices in Birmingham that were taking part in a screening study assessing cardiovascular risk. Patients with an indication for cardiovascular risk-lowering treatment were sent the Beliefs about Medicines Questionnaire (BMQ)-General,17 which is designed to measure attitudes to medicines in general: with higher scores indicating a greater belief that medicines are harmful and overused. Of 4520 patients sent the questionnaire, 2860 (63%) returned a completed BMQ-General. In order to sample responders with extreme views, as well as those who held moderate beliefs, and taking into account the fact that different studies categorise scores in various ways,18–20 patients’ scores were divided into tertiles so that scores of 8–15 were categorised as low, 16–22 as medium, and 23–40 as high.
How this fits in
Trials have shown that a polypill can lead to important reductions in blood pressure and serum cholesterol, thereby reducing cardiovascular morbidity. One patient survey suggested high acceptability of a polypill for primary prevention, but there have been no detailed data on patients’ attitudes. This first qualitative study of the attitude of patients towards a polypill found substantial resistance to all people over a specific age taking such a pill for the primary prevention of cardiovascular disease. Patients were particularly concerned about: taking a pill if it was not ‘necessary’; side effects; inflexibility; and minimal monitoring.
Patients were included to reflect the variety of sociodemographic, individual, and practice characteristics (Table 1) to allow a diverse range of responses to emerge. Fifty-nine responders were selected and approached by letter to participate in the interview study.