We narratively reviewed 32 systematically identified, controlled studies that assessed interventions designed to improve adherence to statins.

Absolute increases in mean adherence to statins were modest (+7 to +22 %) for successful interventions that used comparable adherence measures (medication possession ratio, proportion of days covered, or similar). Nevertheless, increased adherence to statins generally also improved cholesterol measures.

Cognitive education delivered face-to-face multiple times was the most consistent feature of successful interventions, although successful examples of other intervention types (e.g. behavioural counselling), were also found.

Most interventions that improve adherence to statins are resource intensive, despite only having modest effects. Mobile health platforms may be a more efficient alternative, but have not been well explored in relation to statin use.