Table 2

Selection of quotes from the interviews

Quote 1Obviously, convenience-wise, it[the polypill] was a lot easier because I think I take about six or seven tablets a day…and, obviously, with the polypill, it makes it a lot easier. So, there are only a few tablets to remember. [Trial participant, UK]
Quote 2I have a bag with all my pills and…quite often, half way through taking my pills, I get disturbed, a phone might ring, my wife speaks to me, I then have to think, well did I actually take a pill from the package I'm holding…and I can't remember…with the polypill it wouldn't have mattered so much. It would have been less pills and it's much easier to know…because it's just a lovely packet, you can tell, normally when you have taken the pill or not. Because, you know, there's a big hole left if you have taken it, whereas with the other pills, you know I'm taking from different ends, I ignore the days on the back and things like that. [Trial participant, UK]
Quote 3In my view, there is a small flaw in the trial, because the trial is looking for compliance and adherence. Any person who is given a study drug is likely to be more adherent, more compliant. Any person who is asked to continue the same old drug is likely to be less compliant or at least less interested in the trial. [Cardiologist, India]
Quote 4He stopped[anticoagulants] for eight months…we told him…it doesn't cost much, maybe 5 rupees, 10 rupees. If you don't have money, you can skip your dinner or lunch, but don't skip this medicine. So sometimes we use very emphatic statements like that to tell the importance of these medicines. [Cardiologist, India]
Quote 5When I came here for a check-up…they told me that there is going to be a lottery for drugs…There will be one capsule which combines 3–4 drugs and rest will be prescribed to me. It will reduce my expenses. They gave 5–6 months’ worth of drugs in one instalment and then for 5–6 months in the second…the biggest benefit is that I do a job and this saved me money. I used to buy medicines worth 1000 rupees from the market, but after this, I had to buy medicines worth only 300–400 rupees. [Trial participant, India]
Quote 6I have come to recognize them over time. For example, one capsule has a red stripe; there is a white pill that I now know that I have to take again in the morning. There is a white capsule that I have to take in the night. [Trial participant, India]
Quote 7“Then this is 1 tablet, that is 4, it is easier to have a single tablet…yes, I can't read, I used to recognize them…yes, by the colour. Sometimes I could make it out also…when I had to buy from the market…I took the medicine that I had to take in the evening, then had it again…this happened a couple of times. [Trial participant, India]
Quote 8…if they've not had a heart attack then really they feel healthy. And most people don't like taking loads of things…[Cardiologist, UK].
Quote 9If someone’s risks are that high, I think doctors will want to fine tune it[CVD medication] themselves…and if risks aren’t that high, I don’t think you’ll get long term compliance…with patients…until you have made it clear that this is a long term strategy, there's no point…they go away and take it and think, oh I don’t want to. So I think…taking time to start people on medication is really, really important…understanding what it’s all about. So people aren’t afraid that they’re turning into grandma by taking tablets at 40 years old. [General Practitioner, UK]
Quote 10…it's an opportunity for me to be monitored if you like because I suppose when I first had the heart attack I was obviously in hospital then had some therapy afterwards. Once that was finished it was sort of “Here are your pills, off you go and get on with it”. You got all the advice and everything else and stuff like that. But then after a while I remember going to the doctor about something completely different but asked the question: “What happens now?” “Am I monitored yearly or what happens.” “Who looks after me?” That was initially soon after the heart attack. So I just thought it's[trial participation] a good opportunity to get an idea of how I'm doing but then it's also of some benefit to you guys. So it benefits both of us really. [Trial participant, UK]
Quote 11I always believed before taking these that I would be the sort of person—because before having the heart attack for many years I was diagnosed as having high blood pressure, I was forgetful so I would sometimes go days without taking the pills. But since having the heart attack: no, I've become very regimented with it. So I don't think I've ever forgotten even if we go on holiday. I've got a pill box and it's all set out. [Trial participant, UK]
Quote 12I don’t forget. It has become my daily routine for the last 1¾ years. I fear that if I don’t take the medicine, the pain will start again or I will become breathless. [Trial participant, India]
Quote 13They may not be concerned about taking the medicine. This could be the reason. I start worrying if I don’t take my medicine. So, I don’t forget it. If they don’t feel pain, they become careless. [Trial participant, India]
Quote 14I think these are all psychosocial problems. Anybody who is taking too much alcohol, too much smoking, something is wrong with his mind; his training has been negative or something. He knows that smoking is bad but still does it, they are less compliant. [Cardiologist, India]
Quote 15I take a multivitamin when I’m working nights…well, you just don’t eat as well when you’re working the night shift…you have to rely on things like ready meals…believe me. Everybody says, “Oh, no, you could make a good dinner and take it with you.” No, no, no! It just doesn’t happen on nights…I work seven nights in a row and some of them are 12-hour shifts and when you go home, you’re tired. You’re not going to start doing that. [Trial Participant, UK]
Quote 16The day there is tension I smoke. The day I give up smoking, God willing I will not need to have medicines. [Trial participant, India]
Quote 17Well most of the research shows that roughly I think a third of patients…take it if at all…a third take it badly and a third take it correctly…the best compliance is with an informed patient and once daily medication with as fewer drugs as possible, so I can see the attraction of the polypill. [General practitioner, UK]
Quote 18Sometimes I am having side effects because of your capsule…cough only…we will use only 25 every month, in that 25 also we will drop [skip] five [or] six, but it will stop. But when it stops I will continue again…[Trial Participant, India]