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Primary non-adherence is an important, yet understudied aspect of reduced effectiveness of pharmacotherapy. This review summarizes the frequency, impact, reasons, predictors, and interventions regarding primary non-adherence to cardiovascular\/cardiometabolic drugs. The current literature reveals a high prevalence of primary non-adherence. The individual risk of primary non-adherence is determined on multiple factors, e.g., primary non-adherence of lipid-lowering drugs is higher compared to antihypertensive medications. However, the overall rate of primary non-adherence is\u2009&gt;\u200910%. Additionally, this review identifies specific areas for research to better understand why patients forgo evidence-based beneficial pharmacotherapy and to explore targeted interventions. At the same time, measures to reduce primary non-adherence\u2014once proven to be effective\u2014may represent an important new opportunity to reduce cardiovascular diseases.<\/jats:p>","DOI":"10.1007\/s00392-023-02230-3","type":"journal-article","created":{"date-parts":[[2023,5,20]],"date-time":"2023-05-20T07:02:01Z","timestamp":1684566121000},"page":"1103-1116","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Not obtaining a medication the first time it is prescribed: primary non-adherence to cardiovascular pharmacotherapy"],"prefix":"10.1007","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5876-7322","authenticated-orcid":false,"given":"Martin","family":"Schulz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2620-9323","authenticated-orcid":false,"given":"Ulrich","family":"Laufs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,20]]},"reference":[{"key":"2230_CR1","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/S0140-6736(18)32203-7","volume":"392","author":"GA Roth","year":"2018","unstructured":"GBD 2017 Causes of Death Collaborators, Roth GA et al (2018) Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. 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