ArticleJACC. Advances2025
Developing a Multilevel Polypill Implementation Bundle for Patients With Heart Failure With Reduced Ejection Fraction.
Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Asia at the Epicenter of the Global Cardiometabolic Shift.JACC. Asia · 2026Review
- Provider Preferences About a Polypill for Heart Failure With Reduced Ejection Fraction: Development of a Multicenter Physician Survey Containing a Discrete Choice Experiment.Journal of cardiac failure - intersections · 2026Article
- A Fixed-Dose Solution for a Complex Problem: Can Polypills and Implementation Science Improve GDMT Uptake in HFrEF?JACC. Advances · 2025Article
- Behavioral Intelligence in Action: Implementation Science and Cardiovascular Learning Health Systems.JACC. Advances · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundA polypill that contains multiple guideline-directed medical therapies for heart failure with reduced ejection fraction (HFrEF) has been proposed to improve HFrEF outcomes. The factors affecting implementation of a polypill-based strategy for HFrEF are unknown.
objectivesThis study aims to identify determinants that could affect a polypill-based strategy for HFrEF, design a multilevel HFrEF polypill implementation bundle, and illustrate how the bundle could improve outcomes.
methodsFrom April to December 2023, we conducted a convergent parallel mixed methods study at Washington University in St. Louis and the University of California-San Francisco to gather patient (N = 9) and provider (N = 22) perspectives on a polypill-based approach to HFrEF care guided by the Consolidated Framework for Implementation Research v2.0. We then used the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change Matching Tool to select strategies for a multilevel implementation bundle and mechanism mapping to elucidate how the bundle could improve patient outcomes.
resultsStakeholder interviews revealed four themes that affect implementation of a polypill-based approach to HFrEF. The current state of HFrEF care was the organizing theme, influenced by 3 additional themes: awareness of new innovations, assessing innovation appropriateness, and building competency in HFrEF care. Based on these themes, we developed a multilevel HFrEF polypill implementation bundle with 7 domains and illustrate how the bundle could improve outcomes with a directed acyclic graph.
conclusionsThis study illustrates the development of a multilevel HFrEF polypill implementation bundle that can be further tailored to improve HFrEF care in undertreated populations globally.
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