A novel four-drug regimen for heart failure with reduced ejection fraction (HFrEF) extends
patients' life expectancy by an average of 6 years compared to traditional therapies, in
addition to improving quality of life. Unfortunately, uptake of this complex multi-drug
regimen has been low, especially among underserved communities with barriers to medication
adherence. Although combination tablets have transformed access to care for conditions such
as HIV and tuberculosis, no combination pill is available for HFrEF.
In the proposed study, the investigators will utilize inexpensive over-encapsulation
techniques to develop a novel combination pill ("polypill") for patients with HFrEF. In Aim
1, the investigators will conduct stakeholder interviews with patients, providers, and
pharmacists to inform the design of a HFrEF polypill. In Aim 2, the investigators will
conduct a pilot, single-center, crossover randomized clinical trial to investigate whether,
compared to usual care, a HFrEF polypill increases medication adherence among 20-40 adults
with HFrEF. Given the high daily pill burden among patients with HIV and HFrEF, the
investigators aim to recruit a subgroup of patients with HIV (~10-20 participants) in
addition to a subgroup of patients without HIV (~10-20 participants).