Interventions to improve adherence among patients prescribed statins for primary prevention of cardiovascular diseases: a systematic review and meta-analysis
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Aims: This study aims to identify the interventions used to improve adherence in patients receiving statins for primary prevention of cardiovascular disease and to determine the effectiveness of these interventions. Methods and results: This systematic review and meta-analysis was conducted according to PRISMA guidelines. The protocol was registered with PROSPERO (CRD42024587573). Search was performed in MEDLINE (PubMed), SCOPUS, EMBASE, and CINAHL for studies published between January 2000 and May 2024. Thirty-four studies with five intervention strategies met the eligibility criteria, of which 18 were non-cluster randomized controlled trials (ncRCTs), 10 were cluster RCTs (cRCTs), and 6 were non-randomized studies of interventions (NRSI). The intervention strategies were multifaceted, education-based, behaviour change/monitoring, regimen modification, and incentive-based. Meta-analysis showed that the pooled risk ratio (RR), relative to control, for ncRCTs was 1.12 (95% CI: 1.00–1.25); for cRCTs, it was 1.50 (95% CI: 0.97–2.31); and for NRSIs, it was 1.37 (95% CI: 0.95–1.98), with point estimates in favour of the intervention arms. High heterogeneity was observed across studies, with I2 > 91%. Subgroup analysis suggested that relative to controls, there was a potential benefit of digital components in both ncRCTs (RR = 1.08, 95% CI: 1.03–1.12) and cRCTs (RR = 1.30, 95% CI: 1.07–1.59) and education-based (RR = 1.05, 95% CI: 1.02–1.09) and/or multifaceted interventions (RR = 1.11, 95% CI: 1.07–1.16) in ncRCTs. The interventions were effective in lowering LDL cholesterol but were not as effective in lowering total cholesterol. Conclusion: The study found heterogeneous evidence with limited certainty suggesting a potential modest improvement in statin adherence with interventions, where the effect sizes were small.
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Amiri, M. (2020) · Biometrics & Biostatistics International Journal · doi:10.15406/bbij.2020.09.00320 · Cited by 3 · see citing works
Rakhshanda, S., Liaw, S., Rhee, J., et al. (2024) · Studies in health technology and informatics · doi:10.3233/shti240362 · Cited by 3 · see citing works
Self-citationPeasah, S. K., Liu, Y., Krohe, S., Campbell, V., Lee, C. S., Mathur, A., Stevenson, H., Manolis, C. H., & Good, C. B. (2023) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2024.30.1.43 · Cited by 2 · see citing works
Palacio, A. M., & Hazel-Fernandez, L. A. (2015) · Journal of Clinical Trials · doi:10.4172/2167-0870.1000189 · Cited by 2 · see citing works
Corn, G., Lund, M., Hlatky, M. A., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.025465 · Cited by 1 · see citing works
Bochkareva, E., Boytsov, S. A., Drapkina, O. M., et al. (2025) · PubMed · doi:10.22088/cjim.16.3.458
Flagged first, then by citations
Research works printed but not linked: 2
- Rakhshanda, 2024, Protocol for systematic review and meta-analysis of assessing the effectiveness of various interventions to address statin intolerance and improve adherence among patients at risk of cardiovascular diseases, PROSPERO, 2024, CRD42024587573
- Buhse, 2017, Diabetologia, S347
Cited by
Sorted by citations
Highlighting the latest research: April 2026
Palmer, S. J. (2026) · British Journal of Cardiac Nursing · doi:10.12968/bjca.2026.0025
New Dyslipidemia Guidelines Lower the Lipid Treatment Goals and Raise the Bar for Clinical Practice
Greenland, P., & Lasser, K. E. (2026) · JAMA · doi:10.1001/jama.2026.11091
Appraising the Efficacy of Statins in the Management of Cardiovascular Disease Among Patients
Aamir, M., Anwer, H., Ullah, A., Mahroof, I., Tufail, M., & Aziz, F. (2026) · Biological and Clinical Sciences Research Journal · doi:10.54112/bcsrj.v7i6.2349
- Authors
- Rakhshanda, S., Briggs, N. E., Rhee, J., Rye, K.-A., Liaw, S.-T., & Jonnagaddala, J.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Jonnagaddala, Jitendra
- ORCID
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2026-03-27
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W7141021479
- Semantic Scholar
- 0cbceb45fd8249807c90ff13d3d64ca914b8f167
- Cited by
- 3
- References
- 87
- Citations by year
- 2026: 3
- FWCI
- 6.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Preventive Cardiology (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- Australian National Health and Medical Research Council (GNT1192469)
- UNSW Sydney
- Google Cloud Research (297 GCP19980904)
- Nvidia
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- statin adherence, medication adherence interventions, primary prevention of cardiovascular disease, patient education, behaviour change interventions, digital interventions, incentive-based interventions, LDL cholesterol lowering, total cholesterol, multicomponent intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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