A large randomized clinical trial found that simple digital outreach can modestly improve statin refill rates among adults with cardiovascular disease or elevated cardiovascular risk who had recently failed to refill their medication.
Published online by JAMA on August 29, 2026, the ADHERE-ASCVD trial analyzed 20,604 adults in an integrated Northern California health system. Participants were assigned to secure patient-portal messages, SMS text messages, nonsecure email or usual communication.
The messages reminded participants to refill their statin, explained available refill options and reinforced the importance of regular use. Within 14 days, 14.4% of people receiving initial digital outreach had refilled their prescription, compared with 12.0% receiving usual communication.
Among more than 13,000 people who did not respond initially, a second outreach increased 14-day refills to 13.0%, compared with 10.4% in the usual-communication group. Changing the communication channel did not meaningfully outperform repeating the same type of outreach.
At 28 days, cumulative refill rates were 24.9% with any digital outreach versus 21.2% with usual communication. The absolute difference was small, but the trial suggests that low-cost reminders embedded in routine care may help address one practical reason preventive treatment fails: patients do not consistently obtain refills.
The findings do not show that text messages or emails replace clinician counseling, medication review or follow-up. The study took place in one integrated health system and included adults who had access to all the communication methods tested. Refill behavior also does not prove that medication was taken as prescribed.
Statins are used to reduce cardiovascular risk in people with atherosclerotic cardiovascular disease or certain high-risk profiles. Anyone who has stopped or delayed a statin should discuss side effects, cost, dosing or alternatives with a clinician rather than restarting or discontinuing treatment independently.
