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Trial registered on ANZCTR
Registration number
ACTRN12612000980831
Ethics application status
Approved
Date submitted
10/09/2012
Date registered
11/09/2012
Date last updated
9/09/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Assessing the impact of a four-in-one 'polypill' on adherence to essential medications in those at highest risk of cardiovascular disease
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Scientific title
Meta-analysis of trials assessing combination therapy to improve adherence to essential medications in patients with established disease or at high risk of cardiovascular disease
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Secondary ID [1]
281197
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nil
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Universal Trial Number (UTN)
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Trial acronym
Single Pill to Avert Cardiovascular Events Collaboration (SPACE)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cardiovascular Disease
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Condition category
Condition code
Cardiovascular
287710
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Participants in the active arm of each trial have been allocated to either Red Heart Pill Version 1c (40mg simvastatin, 75mg aspirin, 10mg lisinopril, 50mg atenolol) once daily for duration of trial or
Red Heart Pill Version 2c (40mg simvastatin, 75mg aspirin, 10mg lisinopril, 12.5mg hydrochlorothiazide) once daily for duration of trial. The version prescribed is according to the physician's discretion. Each trial has an average of between 12 and 18 months follow-up. The main objective is to determine if combining 4 medications into one pill improves adherence to these medications.
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Intervention code [1]
285660
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Not applicable
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Comparator / control treatment
The comparator in each of the trials included in the meta-analysis is 'usual care' which is defined as whatever treatment the treating physician deems appropriate for that patient's circumstances.
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Control group
Active
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Outcomes
Primary outcome [1]
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Self-reported current use of antiplatelet, statin, and combination (>= 2) blood pressure lowering therapy. Current use of a medication will be defined as taking the medication for at least 4 days during the week preceding the visit
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Assessment method [1]
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Timepoint [1]
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12 months
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Primary outcome [2]
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Change in systolic blood pressure
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Assessment method [2]
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Timepoint [2]
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12 months
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Primary outcome [3]
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Mean change in LDL cholesterol from baseline
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Assessment method [3]
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Timepoint [3]
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12 months
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Secondary outcome [1]
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Mean changes in Total cholesterol and other lipid fractions (HDL-cholesterol, triglycertides, non-HDL cholesterol) from baseline
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Assessment method [1]
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Timepoint [1]
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12 months
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Secondary outcome [2]
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Change in diastolic blood pressure
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Assessment method [2]
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Timepoint [2]
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12 months
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Secondary outcome [3]
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Self-reported current use (defined as at least four days in the week preceding the visit) of antiplatelet, statin, and at least one blood pressure lowering therapy
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Assessment method [3]
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Timepoint [3]
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12 months
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Secondary outcome [4]
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Changes in plasma creatinine
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Assessment method [4]
299121
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Timepoint [4]
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12 months
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Secondary outcome [5]
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Quality of life (EQ5D)
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Assessment method [5]
299122
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Timepoint [5]
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12 months
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Secondary outcome [6]
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Cardiovascular, non-cardiovascular and all-cause mortality
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Assessment method [6]
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Timepoint [6]
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End of study
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Secondary outcome [7]
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New onset Diabetes Mellitus. Defined as new diagnosis of Diabetes Mellitus as recorded in trial documentation or fasting plasma glucose > 7.0 mmol/L during the study period.
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Assessment method [7]
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Timepoint [7]
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End of study
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Secondary outcome [8]
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Cardiovascular events, defined as a composite of: (i) All coronary heart disease events including death from coronary heart disease, sudden cardiovascular death, non-fatal myocardial infarction, coronary artery bypass graft, percutaneous transluminal coronary angioplasty (with or without stenting) and hospitalisation for unstable angina; (ii) All heart failure events leading to death or requiring hospital admission. (iii) All cerebrovascular disease events including death from cerebrovascular disease, non-fatal stroke, transient ischaemic attack and sub-arachnoid haemorrhage (iv) All peripheral arterial events, including death due to peripheral vascular disease, new symptomatic claudication, amputation due to ischaemia, dissection, and peripheral arterial revascularisation procedures (such as: carotid endarterectomy or stent, open repair or stenting of aortic aneurysm or dissection, limb revascularisation, e.g. femoral-popliteal bypass surgery) or new onset chronic leg ulceration due to arterial insufficiency (v) CV events with and without procedures
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Assessment method [8]
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Timepoint [8]
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End of study
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Secondary outcome [9]
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Each of the four components of the secondary cardiovascular endpoint as described in Secondary Outcome 8
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Assessment method [9]
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Timepoint [9]
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End of study
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Eligibility
Key inclusion criteria
All patients included in SPACE Collaboration trials
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
As per the individual trials
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Study design
Purpose
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Duration
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Selection
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Timing
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/12/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
3200
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
4541
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Country [2]
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Ireland
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State/province [2]
4542
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Country [3]
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Netherlands
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State/province [3]
4543
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Country [4]
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India
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State/province [4]
4544
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Country [5]
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United Kingdom
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State/province [5]
4545
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Dr Reddy's Laboratories
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Address [1]
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Door No 8-2-337,
Road No 3, Banjara Hills,
Hyderabad - 500034.
Andhra Pradesh
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Country [1]
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India
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Primary sponsor type
Other
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Name
The George Institute for Global Health
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Address
Level 10, KGV Building
Missenden Rd
Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
284797
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Country [1]
284797
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288010
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Ethics committee address [1]
288010
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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21/05/2008
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Approval date [1]
288010
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Ethics approval number [1]
288010
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Summary
Brief summary
An international collaboration of investigators has been established with the aim of assessing the benefits and risks of polypill-based care compared with usual care in populations at high risk of cardiovascular disease (CVD). Several trials are planned, as the effectiveness and economic impact of a polypill-based strategy may vary substantially between countries, given the varying influence of the health-care system within which the intervention is delivered. Primary outcomes for the individual patient data meta-analysis will include self-reported current use of antiplatelet, statin, and combination (>= 2) blood pressure lowering therapy at 12 months, and change in systolic blood pressure (SBP) and total cholesterol from baseline to 12 months. Non-inferiority margins of 3mmHg for SBP and 0.3 mmol/L for total cholesterol have been pre-specified. Secondary outcomes will include change in cholesterol fractions, diastolic blood pressure and creatinine from baseline to 12 months, quality of Life, new onset diabetes mellitus, mortality (cardiovascular, non-cardiovascular and all cause) and a composite outcome of cardiovascular events (including all coronary heart disease events, heart failure events leading to death or requiring hospital admission, cerebrovascular events and peripheral arterial events).
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Anthony Rodgers
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Address
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The George Institute for Global Health
PO Box M201
Missenden Rd
Camperdown NSW 2050
Australia
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Country
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Australia
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Phone
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+61 2 9657 0375
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ruth Webster
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Address
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The George Institute for Global Health
PO Box M201
Missenden Rd,
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 9993 4557
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Ruth Webster
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Address
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The George Institute for Global Health
PO Box M201
Missenden Rd,
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 9993 4557
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effectiveness of fixed dose combination medication ('polypills') compared with usual care in patients with cardiovascular disease or at high risk: A prospective, individual patient data meta-analysis of 3140 patients in six countries.
2016
https://dx.doi.org/10.1016/j.ijcard.2015.12.015
Embase
Impact of switching to polypill based therapy by baseline potency of medication: Post-hoc analysis of the SPACE Collaboration dataset.
2017
https://dx.doi.org/10.1016/j.ijcard.2017.09.162
N.B. These documents automatically identified may not have been verified by the study sponsor.
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