Digital outreach through a variety of formats may improve short-term statin refill consistently across a broad age range, according to a prespecified analysis of the ADHERE-ASCVD trial presented at AHA 2026 and simultaneously published in JACC.

The pragmatic ADHERE-ASCVD trial randomized 20,604 adults (41% women; 11% Black, 34% Hispanic) with ASCVD or the presence of type 2 diabetes (indicating high ASCVD risk) within the Kaiser Permanente Northern California health system 1:1:1:1 to secure portal messaging, SMS text messaging, standard nonsecure email or usual communication. All patients had a current statin prescription with prior nonadherence, and access to all three digital modes of communication.

Mean age of patients was 55 years, with 13.6% (2,792) aged <45 years, 74.5% (15,348) aged 45-64 years and 12.0% (2,464) aged ≥65 years.

Results showed that the effect of digital outreach was consistent across age groups, with no evidence of heterogeneity by age. For participants aged <45, 45-64 and ≥65 years, adjusted risk differences were 1.4 percentage points, 2.4 percentage points and 3.2 percentage points, respectively (p interaction=0.66; p trend=0.38). Older age was associated with higher 14-day satin refill rates overall.

“These findings are reassuring and suggest that age alone may not be a major barrier to the effectiveness of automated, pragmatic, health system embedded digital health interventions,” write investigators Baiyang Sun, PhD, MPH, and colleagues.

However, they note that these results were solely among a digitally connected patient population. Patients without access to digital communication who would have otherwise been deemed eligible were older (58 years vs. 55 years), and a greater proportion of this population were aged ≥65 years (20.8% vs. 12.0%). The authors also note that only 3.8% of participants were aged 70-75 years, and limited power at age extremes means modest age-related differences in effectiveness cannot be excluded. Additionally, the primary endpoint of 14-day statin refill did not capture longer-term medication adherence.

Explore more simultaneously published research through the JACC Journals at AHA event page, and visit ACC’s AHA 2026 Meeting Coverage page for additional studies, clinical insights and news from the meeting.

Clinical Topics: Prevention

Keywords: AHA Annual Scientific Sessions, AHA26, Diabetes Mellitus, Type 2, Medication Adherence, Secondary Prevention