Evidence mapPaperPMID 40503512Full record

ArticleEClinicalMedicine2025

Interventions to improve adherence to lipid-lowering drugs: a systematic review and meta-analysis.

Deborah Keng Wai Yow, Wei Jie Ang, Hao Jeun Yap, Sakura Ito, Jintana Liu, Junsuk Ko, Doreen Su-Yin Tan, Alberto Lorenzatti, Chin-Siang Ang

Abstract read
In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Deborah Keng Wai YowDepartment of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Singapore.
Wei Jie AngDepartment of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Singapore.
Hao Jeun YapDepartment of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Singapore.
Sakura ItoLee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Jintana LiuLee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Junsuk KoDuke-National University of Singapore Medical School, Singapore.
Doreen Su-Yin TanDepartment of Pharmacy and Pharmaceutical Sciences, Faculty of Science, National University of Singapore, Singapore.
Alberto LorenzattiDAMIC Medical Institute, Cordoba, Argentina.
Chin-Siang AngLee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Poor medication adherence to lipid-lowering medications (LLMs) remains a barrier in reducing the burden of cardiovascular disease (CVD). We sought to review interventions aimed at improving adherence to LLMs for the primary or secondary prevention of CVD, and evaluate their effectiveness on patient outcomes. Methods: A systematic review and meta-analysis was performed according to PRISMA guidelines. Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, and CINAHL, were searched for studies published between January 1, 2016 and October 3, 2024, reporting randomised controlled trials on interventions to enhance adherence to LLMs. Cochrane's Risk-of-Bias (ROB-2) tool was utilised for quality appraisal. A narrative analysis and a random-effects meta-analysis was conducted, with adherence to LLMs as main outcomes. Pooled effects were calculated using Standardised Mean Difference (SMD) or Odds Ratios (OR). The review's protocol is available on Open Science Framework (https://osf.io/9gx5h). Findings: The systematic review and meta-analysis included 35 and 15 studies, respectively. Participants (n = 51,824) had a mean age ranging 50.2-74.4 years. 6 distinct interventions were employed; most were conducted in primary care settings and employed intensified patient care. Overall, interventions assessed with continuous (SMD 0.17, 95% CI [0.04, 0.31]) and dichotomous (OR 1.26, 95% CI [1.08, 1.47]) measures showed improvements in adherence. Participants who engaged in complex behavioural approaches exhibited improved adherence in dichotomous (OR 1.74, 95% CI [1.17, 2.58]) and continuous outcomes (SMD 0.35, 95% CI [0.15, 0.54]). Pooled estimates suggest no differences in physiological outcomes between the groups. A risk-of-bias assessment following worst-case scenario analysis assessed 3 studies as "low risk", 11 as "high risk", and 21 as "unclear risk". Interpretation: Current interventions bring about improvements in medication adherence, but such improvements are not sustained over the long-term. For real world and practice implications, interventions must be multipronged in nature, addressing a combination of at least two dimensions of medication adherence. Additional global studies, particularly long-term randomised controlled trials, are required to corroborate our findings. Funding: None.

Indexed as

Cardiovascular diseaseHyperlipidaemiaMedication adherenceMeta-analysisStatin

Identifiers

PMID40503512
PMCPMC12158495

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.