Prevention & lipidsRandomised controlled trial
Digital Outreach to Improve Statin Refills in Patients With Low Statin Adherence
- Randomised controlled trial
- pragmatic
- health system-embedded
- PROBE
- 2-stage sequential, multiple assignment, randomized trial (SMART) design
Authors' conclusion
Among adults with a statin indication and recent statin nonadherence, adaptive outreach improved short-term refill vs usual communication. A second outreach produced additional gains among initial nonresponders, although switching communication modalities provided no additional benefit.
Study context
- Population
- Adults ≥18 y with established atherosclerotic cardiovascular disease (ASCVD) or high ASCVD risk and recent statin nonadherence, Kaiser Permanente Northern California
- Participants
- 20,604 adults
- Comparison
- Digital outreach vs usual communication
- Primary endpoint
- 14-day statin refill following each randomization
- Follow-up
- 14 days (28-day )
Primary result
As reported in the abstract
14-day statin refill, initial outreach · 14 days
Each group vs usual communicationAdjusted risk difference, percentage points (95% CI)
Digital outreach
2.3(1.3–3.4)
Each group vs usual communicationAdjusted relative risk (95% CI)
Digital outreach
1.20(1.10–1.30)
Further findings
| Outcome | Digital outreach | Usual communication | adjusted risk difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| 14-day statin refill after second-stage outreach (initial nonresponders) · 14 days — Second-stage outreach vs Usual communication | Not reported in the abstract | 10.4% | 2.5 (1.3–3.7) | |
| −2024Difference, percentage points (linear scale) |
| Outcome | Digital outreach | Usual communication | Estimate | |
|---|---|---|---|---|
| 14-day statin refill after second-stage outreach (initial nonresponders) · 14 days — Second-stage outreach vs Usual communication | adjusted RR 1.25 (95% CI 1.11–1.39) | |||
| 14-day statin refill, switching vs repeating modality (initial nonresponders) · did not improve refill | adjusted RR 1.06 (95% CI 0.94–1.17) | |||
| Cumulative statin refill · 28 days | Not reported in the abstract | 21.2% | adjusted HR 1.21 (95% CI 1.13–1.30) | |
| 0.512Ratio (log scale) |
- 14-day statin refill after second-stage outreach (initial nonresponders): Second-stage outreach 13.0%
- 14-day statin refill, switching vs repeating modality (initial nonresponders): Switching communication modalities 13.2%
- 14-day statin refill, switching vs repeating modality (initial nonresponders): Repeating the same modality 12.5%
- Cumulative statin refill: Any digital outreach 24.9%
Prespecified subgroups
- Results consistent across prespecified subgroups
Original publication
Digital Outreach to Improve Statin Refills in Patients With Low Statin Adherence. JAMA. Published 29 August 2026. doi:10.1001/jama.2026.16372
Summarised from the published abstract; every number is checked against it