Digital Outreach to Improve Statin Refills in Patients With Low Statin Adherence: The ADHERE-ASCVD Randomized Clinical Trial.

Adaptive digital outreach in Kaiser Permanente Northern California increased 14-day statin refill among 20,604 adults with ASCVD/high ASCVD risk and recent nonadherence (14.4% vs 12.0%).

• Why it matters: Statin nonadherence drives preventable cardiovascular events, yet most outreach approaches are static and lack randomized trial evidence for improving short-term refills.
• What they did: In a pragmatic PROBE SMART trial, participants were randomized to portal messaging, SMS/text, nonsecure email, or usual communication, with a second-stage randomization for initial nonresponders within 14 days.
• The result: Among initial nonresponders, a second outreach further increased refill (13.0% vs 10.4%), while switching modalities did not (13.2% vs 12.5%); any digital outreach improved cumulative 28-day refill (24.9% vs 21.2%).

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