Digital Outreach Improves Statin Adherence in High-Risk Patients

Adaptive digital outreach significantly improves short-term statin adherence among adults with atherosclerotic cardiovascular disease (ASCVD), or high ASCVD risk, who have reported nonadherence, according to a study published in JAMA.¹

With digital outreach performing better than usual communication, researchers encourage health systems to adapt similar initiatives to improve cardiovascular outcomes moving forward.

“Medication adherence directly influences the extent to which statins prevent CVD events, including mortality,” wrote the authors of a US Pharmacist article on pharmacists overcoming barriers to statin adherence.² “Poor statin adherence can also increase CVD-related emergency department visits, hospitalizations, and health care costs. A 10% reduction in statin-medication possession ratio is associated with a 5% increased risk for CVD-related hospitalizations.”

READ MORE: Patients With CVD Trust Pharmacists, Underuse Preventive Services

The landmark ADHERE-ASCVD (NCT07522645) pragmatic clinical trial evaluated a sequential, multiple-assignment, randomized trial (SMART) design to address this precise medication implementation gap.¹

The Power of the Digital Nudge

Among 20,604 adults with established ASCVD or type 2 diabetes and low statin adherence, researchers randomized participants to receive secure portal messaging, SMS text messages, nonsecure emails, or usual communication. The initial digital outreach yielded a 14.4% refill rate in 14 days compared with 12% under usual communication, showing that low-intensity digital nudges can trigger prompt patient action.

Secure portal messaging achieved the highest success at 14.9%, followed by SMS text messaging at 14.4% and nonsecure email at 13.9%. For patients who ignored the first reminder, sending a second message boosted subsequent refill rates from 10.4% up to 13%.¹

Switching the communication channel for the second nudge provided no statistical benefit compared with simply repeating the original modality, which means health care systems can safely repeat their most feasible communication channels.

Expanding the Pharmacist’s Role in Cardiovascular Care

These findings are highly relevant as pharmacists face expanded responsibilities under updated cholesterol clinical guidelines. The new guidelines shift clinical focus toward evaluating a patient's lifetime risk of CVD, demanding earlier and more aggressive therapeutic interventions.³

Pharmacists are leveraging tools like the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) risk calculator to identify vulnerable, high-risk individuals. In secondary prevention, pharmacists are essential for intensifying lipid-lowering therapies, navigating prior authorizations, and helping patients overcome clinical inertia.

Furthermore, because up to 50% of patients discontinue statin therapies within the first year due to side effects or high copays, pharmacists are positioned to provide personalized counseling and simplify drug regimens. Managing transitions of care from inpatient to outpatient settings is particularly vital, as this is when disruptions in medication adherence are most prone to occur.^2,4

Integrating eHealth and Long-Acting Therapeutics

To combat these chronic adherence hurdles, the health care sector is increasingly turning to eHealth technologies and digital interventions. Digital tools like telemonitoring, mobile applications, and artificial intelligence help personalize medical care, optimize public health resources, and enable continuous patient monitoring to predict cardiovascular risk.⁵

For patients who struggle with daily pill burdens, pharmacists can also facilitate the administration and monitoring of innovative long-acting therapies like inclisiran. This twice yearly subcutaneous small interfering RNA injection offers a powerful alternative that completely bypasses the daily adherence barriers of standard oral statins.⁴

Whether clinical teams deploy adaptive digital outreach or novel long-acting injectables, integrating these innovative technologies and structured clinical pathways into population health workflows represents a major public health victory that can substantially lower the global morbidity and mortality of CVD.⁵

“In this large, health system–embedded randomized clinical trial, adaptive digital outreach improved short-term statin refill among adults with or at high risk for ASCVD and recent low statin adherence,” concluded the authors of the current study.¹ “These findings support adaptive, sequential health system outreach strategies to improve cardiovascular prevention when integrated into population health programs.”

READ MORE: Cardiology Resource Center

REFERENCES

1. Bhatt AS, Liu VX, Sun B, et al. Digital outreach to improve statin refills in patients with low statin adherence: the ADHERE-ASCVD randomized clinical trial. JAMA. August 29, 2026. doi:10.1001/jama.2026.16372

2. Bui A, Kwon J, Kim J, et al. Overcoming barriers to statin adherence. US Pharmacist. 2019;44(6):19-22. https://www.uspharmacist.com/article/overcoming-barriers-to-statin-adherence

3. Tillman J. Pharmacists take on expanded role under new cholesterol guidelines. ASHP News Center. April 29, 2026. Accessed September 3, 2026. https://news.ashp.org/news/ashp-news/2026/04/29/pharmacists-take-on-expanded-role-under-new-cholesterol-guidelines

4. Gerlach A. Pharmacists' role in ASCVD management: integrating inclisiran into patient care. Pharmacy Times. September 4, 2024. Accessed September 3, 2026. https://www.pharmacytimes.com/view/pharmacists-role-in-ascvd-management-integrating-inclisiran-into-patient-care

5. Restrepo Tique M, Araque O, Sanchez-Echeverri LA. Technological advances in the diagnosis of cardiovascular disease: a public health strategy. Int J Environ Res Public Health. 2024 Aug 16;21(8):1083. doi: 10.3390/ijerph21081083