Not all interventions among studies included in Van Driel et al. (2016) resulted in positive outcomes. The effect on adherence appeared to depend on the type and quality of the intervention. For instance, Fischer et al. (2014) showed that automated pharmacy-led phone reminders to patients who failed to pick up their prescriptions in eight days after a fill date did not affect the number of abandoned prescriptions.[122] On the other hand, Vollmer et al. (2014) noted increased adherence after automated phone call reminders to patients who were due or overdue for a refill.[123] According to the Centers for Disease Control and Prevention (CDC), improving medication adherence is a public health priority and could reduce the economic and health burdens of chronic conditions.[124] The following studies were not included in the systematic evidence review and, thus, were not considered in determining the strength of this recommendation. Rodriguez et al. (2019) estimated adherence to statin therapy is <50% at one year with further decline to <30% after two years.[125] Several sociodemographic characteristics (e.g., patients aged <50 years or >70 years, African American and Hispanic patients, females, patients with low health literacy, and low income) have been associated with lower statin adherence rates.[126] A retrospective cohort analysis of 304,104 patients with prior CVD being treated at the VA showed the risk of mortality was increased by 30% in those with estimated adherence of <50% based on refill history.[125] Conversely, a 10% increase in adherence was found to be associated with a 5% decreased risk of CV-related hospitalizations.[127] Medication adherence is a complex, multifactorial issue that involves the entire healthcare system. 