IMPORTANCE: The Use of a Multidrug Pill In Reducing cardiovascular Events (UMPIRE) trial has shown improved adherence with the use of a polypill strategy when compared with usual medications for @entity65 ( @entity65 ) prevention. To advance from efficacy to impact, we need a better understanding of why and how such a strategy might be deployed in complex health systems. OBJECTIVE: To understand, from the perspective of UMPIRE trial @entity1 and professionals, how and why a polypill strategy improves adherence compared with usual care, why improvement is greater in some subgroups, and to explore the acceptability of a polypill strategy among trial @entity1 and healthcare professionals. DESIGN, SETTING AND @entity1 : A preplanned process evaluation, based on qualitative interviews, was conducted with a subsample of 102 trial @entity1 and 41 healthcare professionals at the end of the UMPIRE trial in India and Europe. RESULTS: Most @entity1 contrasted the simplicity of the polypill with usual medications that they found complex and, for many in India, expensive. @entity1 with low baseline adherence struggled most with complex medication lists, and those without established disease described less motivation to adhere when compared with @entity1 who had already been diagnosed with @entity65 ; @entity1 in the latter group had already undertaken self-directed measures to adhere to @entity65 preventive medicines prior to entering the trial. Taking medication was one of many adaptations described by @entity1 ; these included dietary changes, stopping smoking and maintaining exercise. Most @entity1 liked the polypill strategy, although some @entity1 and health professionals were concerned that it would provide less tailored therapy for individual needs. CONCLUSIONS: Adherence to treatment lists with multiple medications is complex and influenced by several factors. Simplifying medication by using a once-daily polypill is one approach to @entity65 prevention that may enhance adherence. Prescribers should also consider the wide variety of adjustments that individuals need to make to cope with daily medication.

Process evaluation of the impact and acceptability of a polypill for prevention of XXXX .

@entity1 :: ('9606', 'Species') :: ['participants', 'Patients', 'patients', 'PARTICIPANTS', 'people'] @entity65 :: ('MESH:D002318', 'Disease') :: ['CVD', 'cardiovascular disease']
@entity65 :: (MESH:D002318,Disease) :: ['cardiovascular disease']
