Getting Personal: Improved Statin Adherence Through Individualized Communication

Background: Statin adherence remains suboptimal for primary prevention despite its proven benefits in reducing the risk of future adverse atherosclerotic cardiovascular disease (ASCVD). We aim to determine the effectiveness of personalized communication in improving adherence rates for the primary prevention of ASCVD. Methods: This was a quality improvement initiative involving three primary care clinics at the Jesse Brown Veteran Affairs Medical Center in Chicago, Illinois. Patients were ages 40-79, without a history of ASCVD and prescribed a statin within the past year. Those with a refill rate < 80% were mailed a letter educating them on their individualized 10-year ASCVD risk and statins’ utility in reducing this risk. Statin adherence data were obtained prior to and 90 days following the intervention to assess for an improvement in composite statin refill rate. A control chart was used before sending the mailed letters to determine if special causes of variation existed prior to intervention. A 2-sample t-test was used to compare the mean daily adherence rates pre- and post-intervention. Results: There was a statistically significant improvement in daily average statin adherence in the 90-day post-intervention period (84.88 ± 0.39 vs 83.40 ± 0.09; p < 0.001). Conclusion: Mailed letters that include individualized ASCVD risk scores may be an effective way of improving adherence to statins among patients with no prior history of ASCVD.