Non-adherence to Statin Treatment: A Narrative Review of Causes, Clinical Impact, and Preventive Strategies.

This narrative review examines the determinants and clinical consequences of non-adherence to statin (HMG-CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase inhibitor) therapy and evaluates evidence-based strategies for improving long-term medication adherence in patients with hyperlipidemia. It is important to note that prescribing treatment alone will not be effective without sufficiently prolonged adherence to prescribed pharmacotherapy. Non-adherence to prescribed treatment represents a significant clinical challenge. In the following article, we have identified the main causes of the phenomenon, its clinical effects, and summarized reports on possible prevention of the phenomenon. The aim of this narrative literature review was to evaluate factors that may negatively impact long-term adherence to statin therapy in patients with hyperlipidemia, and to identify interventions that could improve medication adherence and reduce discontinuation rates during statin therapy. A search of the bibliographic databases, including PubMed and Google Scholar, was conducted using combinations of the terms "statin," "statin therapy," "adherence," "non-adherence," "compliance," "persistence," "discontinuation," "hyperlipidaemia," "lipid disorders," "cardiovascular risk," "statin intolerance," and "adherence interventions." No formal lower date restriction was applied; however, recent clinically relevant studies and systematic reviews were prioritized, while seminal older studies were included where necessary for clinical and conceptual context. Additional relevant publications were identified through manual review of reference lists from selected studies. Articles without direct relevance to statin therapy, animal studies, and publications with limited relevance to the objectives of this review were excluded. Because this was a narrative review, no formal quality assessment or meta-analysis was performed. The evidence was synthesized narratively and organized into three main themes: determinants of statin non-adherence, clinical implications of non-adherence, and strategies to improve adherence. A total of 22 articles were used as the basis for this study, allowing us to provide practical insights into the reasons for non-adherence to statin treatment. A review of the literature indicates that economic factors, psychopathological factors, and cognitive factors all contribute to statin non-adherence. A patient's failure to comprehend the purpose of prescribed treatment, in conjunction with a lack of awareness regarding the consequences of non-adherence, also plays a crucial role in non-adherence to lipid-lowering treatment. It is recommended that patients be made aware of the potential risks associated with non-adherence to statin treatment. Research highlights the crucial role of the physician in building confidence in the provided treatment. It is essential to educate patients from the outset of the treatment about their medication and to provide ongoing support during follow-up visits. This approach may help to reduce the number of patients who discontinue their statin and other prescribed medication treatment.