{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:26:21Z","timestamp":1780082781370,"version":"3.54.0"},"reference-count":67,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Poor adherence to chronic disease treatment may seriously compromise the effectiveness of therapy, characterizing itself as a critical element for the population\u2019s health, both from the point of view of quality of life and health economics. The causes of low adherence are many and can depend on the patient, the physician and the healthcare system. Low adherence to dietary recommendations and lipid-lowering drug therapy for hypercholesterolemia is a widespread phenomenon that may strongly limit the great advantages of serum lipid reduction strategies in primary and secondary cardiovascular prevention. Many patients discontinue treatment, and adherence decreases with time. Increasing therapeutic adherence can have a much greater impact on the health of the population than any other therapeutic advance. There are numerous strategies to increase therapy adherence according to behavior change theories. They concern the doctor and the patient. Some must be implemented at the time of prescription, others later during the follow-up. The active role of the patient in the therapeutic decision and the shared definition of LDL cholesterol targets are of paramount importance. The aim of this narrative review is to summarize evidence on current levels of adherence to lipid-lowering strategies, the causes of the lack of adequate adherence and possible physician-applicable strategies to improve it.<\/jats:p>","DOI":"10.3390\/ijerph20105878","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T10:08:55Z","timestamp":1684490935000},"page":"5878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Challenges in Improving Adherence to Diet and Drug Treatment in Hypercholesterolemia Patients"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1708-272X","authenticated-orcid":false,"given":"Francesco","family":"Baratta","sequence":"first","affiliation":[{"name":"Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9372-3923","authenticated-orcid":false,"given":"Francesco","family":"Angelico","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1199-8454","authenticated-orcid":false,"given":"Maria","family":"Del Ben","sequence":"additional","affiliation":[{"name":"Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/S0140-6736(05)67394-1","article-title":"Efficacy and safety of cholesterol-lowering treatment: Prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins","volume":"366","author":"Baigent","year":"2005","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/JCMA.0000000000000276","article-title":"Second revolution in cardiovascular prevention","volume":"83","author":"Chiang","year":"2020","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ahj.2018.12.007","article-title":"Comparative effectiveness and safety of statins as a class and of specific statins for primary prevention of cardiovascular disease: A systematic review, meta-analysis, and network meta-analysis of randomized trials with 94,283 participants","volume":"210","author":"Yebyo","year":"2019","journal-title":"Am. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"281","DOI":"10.7326\/M17-1566","article-title":"Statin Denial: An Internet-Driven Cult with Deadly Consequences","volume":"167","author":"Nissen","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_6","first-page":"e1082","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1016\/j.cjca.2021.03.016","article-title":"2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults","volume":"37","author":"Pearson","year":"2021","journal-title":"Can. J. Cardiol."},{"key":"ref_8","first-page":"2473","article-title":"Comprehensive efforts to increase adherence to statin therapy","volume":"38","author":"Vonbank","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/j.1365-2125.2006.02828.x","article-title":"Impact of adherence to statins on coronary artery disease in primary prevention","volume":"63","author":"Bouchard","year":"2007","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s00228-009-0673-0","article-title":"Impact of better adherence to statin agents in the primary prevention of coronary artery disease","volume":"65","author":"Perreault","year":"2009","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"304","DOI":"10.4065\/mcp.2010.0575","article-title":"Medication adherence: WHO cares?","volume":"86","author":"Brown","year":"2011","journal-title":"Mayo Clin. Proc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S1474-5151(03)00091-4","article-title":"Adherence to long-term therapies: Evidence for action","volume":"2","year":"2003","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s40119-021-00240-8","article-title":"Real-world Evidence for Adherence and Persistence with Atorvastatin Therapy","volume":"10","author":"Tsioufis","year":"2021","journal-title":"Cardiol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12955-018-0921-z","article-title":"Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: A cross-sectional study","volume":"16","author":"Lee","year":"2018","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e016982","DOI":"10.1136\/bmjopen-2017-016982","article-title":"Economic impact of medication non-adherence by disease groups: A systematic review","volume":"8","author":"Cutler","year":"2018","journal-title":"BMJ Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1093\/ehjcvp\/pvu010","article-title":"ESC guidelines adherence is associated with improved survival in patients from the Norwegian Heart Failure Registry","volume":"1","author":"Fagerland","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Pharmacother."},{"key":"ref_17","first-page":"1","article-title":"Diet, nutrition and the prevention of chronic diseases","volume":"916","author":"Who","year":"2003","journal-title":"World Health Organ. Tech. Rep. Ser."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kebbe, M., Gao, M., Perez-Cornago, A., Jebb, S.A., and Piernas, C. (2021). Adherence to international dietary recommendations in association with all-cause mortality and fatal and non-fatal cardiovascular disease risk: A prospective analysis of UK Biobank participants. BMC Med., 19.","DOI":"10.1186\/s12916-021-02011-7"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.1161\/01.cir.0000437740.48606.d1","article-title":"2013 AHA\/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Eckel","year":"2014","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s11886-011-0221-2","article-title":"Predictors of statin adherence","volume":"13","author":"Mauskop","year":"2011","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2973","DOI":"10.1517\/14656560903376186","article-title":"Non-adherence to statin therapy: A major challenge for preventive cardiology","volume":"10","author":"Bates","year":"2009","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s11883-012-0291-7","article-title":"How do we improve patient compliance and adherence to long-term statin therapy?","volume":"15","author":"Maningat","year":"2013","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1177\/1054773819883177","article-title":"Perceived Barriers to Follow AHA Dietary Recommendations in Hypercholesterolemic Patients","volume":"30","author":"Mahdavi","year":"2021","journal-title":"Clin. Nurs. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.acvd.2012.06.005","article-title":"Cross-analysis of dietary prescriptions and adherence in 356 hypercholesterolaemic patients","volume":"105","author":"Bruckert","year":"2012","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1093\/eurjpc\/zwaa047","article-title":"EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: The DA VINCI study","volume":"28","author":"Ray","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","article-title":"2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)","volume":"37","author":"Piepoli","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.amjcard.2019.04.017","article-title":"Adherence to Blood Cholesterol Treatment Guidelines Among Physicians Managing Patients with Atherosclerotic Cardiovascular Disease","volume":"124","author":"Ramsaran","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1007\/s10557-021-07199-7","article-title":"Switching, Persistence and Adherence to Statin Therapy: A Retrospective Cohort Study Using the Australian National Pharmacy Data","volume":"36","author":"Talic","year":"2022","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"526","DOI":"10.7326\/0003-4819-158-7-201304020-00004","article-title":"Discontinuation of statins in routine care settings: A cohort study","volume":"158","author":"Zhang","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1016\/j.amjcard.2011.01.013","article-title":"Adherence to statin therapy in elderly patients after hospitalization for coronary revascularization","volume":"107","author":"Kulik","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Zhao, B., He, X., Wu, J., and Yan, S. (2020). Adherence to statins and its impact on clinical outcomes: A retrospective population-based study in China. BMC Cardiovasc. Disord., 20.","DOI":"10.1186\/s12872-020-01566-2"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.clinthera.2011.12.011","article-title":"Adherence to statin treatment and health outcomes in an Italian cohort of newly treated patients: Results from an administrative database analysis","volume":"34","author":"Saragoni","year":"2012","journal-title":"Clin. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.clinthera.2010.02.004","article-title":"Results of a retrospective database analysis of adherence to statin therapy and risk of nonfatal ischemic heart disease in daily clinical practice in Italy","volume":"32","author":"Corrao","year":"2010","journal-title":"Clin. Ther."},{"key":"ref_34","first-page":"1146","article-title":"Using Previous Medication Adherence to Predict Future Adherence","volume":"24","author":"Kumamaru","year":"2018","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_35","first-page":"186","article-title":"Identifying adherent patients to newly initiated statins using previous adherence to chronic medications","volume":"27","author":"Majd","year":"2021","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.2147\/PPA.S231873","article-title":"Adherence to Statin Therapy and Attainment of LDL Cholesterol Goal Among Patients with Type 2 Diabetes and Dyslipidemia","volume":"13","author":"Alwhaibi","year":"2019","journal-title":"Patient Prefer. Adherence."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"595","DOI":"10.2337\/diacare.28.3.595","article-title":"Adherence to statin therapy and LDL cholesterol goal attainment by patients with diabetes and dyslipidemia","volume":"28","author":"Parris","year":"2005","journal-title":"Diabetes Care"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2147\/PPA.S340573","article-title":"The Impact of Age and Sex Concordance Between Patients and Physicians on Medication Adherence: A Population-Based Study","volume":"16","author":"Yao","year":"2022","journal-title":"Patient Prefer. Adherence"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Fung, V., Graetz, I., Reed, M., and Jaffe, M.G. (2018). Patient-reported adherence to statin therapy, barriers to adherence, and perceptions of cardiovascular risk. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191817"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e010376","DOI":"10.1161\/JAHA.118.010376","article-title":"Adherence to Statin Therapy Among US Adults Between 2007 and 2014","volume":"8","author":"Colantonio","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1016\/j.amjcard.2015.02.032","article-title":"Relation of nonalcoholic fatty liver disease and Framingham Risk Score to flow-mediated dilation in patients with cardiometabolic risk factors","volume":"115","author":"Pastori","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.numecd.2016.09.011","article-title":"Under-prescription of statins in patients with non-alcoholic fatty liver disease","volume":"27","author":"Baratta","year":"2017","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/bcp.14943","article-title":"Statin liver safety in non-alcoholic fatty liver disease: A systematic review and metanalysis","volume":"88","author":"Pastori","year":"2021","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/joim.13219","article-title":"Reported muscle symptoms during statin treatment amongst Italian dyslipidaemic patients in the real-life setting: The PROSISA Study","volume":"290","author":"Casula","year":"2021","journal-title":"J. Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3213","DOI":"10.1093\/eurheartj\/ehac015","article-title":"Prevalence of statin intolerance: A meta-analysis","volume":"43","author":"Penson","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"806","DOI":"10.7326\/M20-4680","article-title":"Interventions to Improve Statin Tolerance and Adherence in Patients at Risk for Cardiovascular Disease: A Systematic Review for the 2020 U.S. Department of Veterans Affairs and U.S. Department of Defense Guidelines for Management of Dyslipidemia","volume":"173","author":"Reston","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.pcad.2016.02.005","article-title":"The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review","volume":"58","author":"Winter","year":"2016","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1177\/1090198104263660","article-title":"Health promotion by social cognitive means","volume":"31","author":"Bandura","year":"2004","journal-title":"Health Educ. Behav."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1207\/S15324796ABM2302_3","article-title":"A computerized social cognitive intervention for nutrition behavior: Direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers","volume":"23","author":"Anderson","year":"2001","journal-title":"Ann. Behav. Med."},{"key":"ref_50","first-page":"e25248","article-title":"Application of a Social-Ecological Model to Study the Factors Associated with Sarcopenia","volume":"14","author":"Shimamoto","year":"2022","journal-title":"Cureus"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/109019818801500401","article-title":"An ecological perspective on health promotion programs","volume":"15","author":"McLeroy","year":"1988","journal-title":"Health Educ. Q."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ahj.2016.02.006","article-title":"Changes in cardiovascular risk factors after 5 years of implementation of a population-based program to reduce cardiovascular disease: The Heart of New Ulm Project","volume":"175","author":"Sidebottom","year":"2016","journal-title":"Am. Heart J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s12529-015-9531-x","article-title":"Predicting Self-Management Behaviors in Familial Hypercholesterolemia Using an Integrated Theoretical Model: The Impact of Beliefs About Illnesses and Beliefs About Behaviors","volume":"23","author":"Hagger","year":"2016","journal-title":"Int. J. Behav. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1080\/08870446.2011.613995","article-title":"The theory of planned behaviour: Reactions and reflections","volume":"26","author":"Ajzen","year":"2011","journal-title":"Psychol. Health"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1348\/014466601164939","article-title":"Efficacy of the Theory of Planned Behaviour: A meta-analytic review","volume":"40","author":"Armitage","year":"2001","journal-title":"Br. J. Soc. Psychol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1016\/S0735-1097(02)02529-9","article-title":"Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes","volume":"40","author":"Merz","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1177\/0272989X14551638","article-title":"Where is the evidence? A systematic review of shared decision making and patient outcomes","volume":"35","author":"Shay","year":"2015","journal-title":"Med. Decis. Mak."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.pec.2013.01.016","article-title":"Patient-reported use of collaborative goal setting and glycemic control among patients with diabetes","volume":"92","author":"Lafata","year":"2013","journal-title":"Patient Educ. Couns."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1001\/jama.2017.6753","article-title":"Treatment of Cholesterol in 2017","volume":"318","author":"Krumholz","year":"2017","journal-title":"JAMA"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1038\/nrcardio.2013.208","article-title":"\u2018Take as directed\u2019\u2014Strategies to improve adherence to cardiac medication","volume":"11","author":"Tajouri","year":"2014","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1001\/2013.jamainternmed.717","article-title":"Automated outreach to increase primary adherence to cholesterol-lowering medications","volume":"173","author":"Derose","year":"2013","journal-title":"JAMA Intern. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1016\/j.jand.2018.05.011","article-title":"Defining Adherence to Dietary Self-Monitoring Using a Mobile App: A Narrative Review","volume":"118","author":"Payne","year":"2018","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1177\/1062860616656250","article-title":"A Multidisciplinary Patient Navigation Program Improves Compliance with Adjuvant Breast Cancer Therapy in a Public Hospital","volume":"32","author":"Castaldi","year":"2017","journal-title":"Am. J. Med. Qual."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1023\/A:1008627824731","article-title":"A patient diary as a tool to improve medicine compliance","volume":"21","year":"1999","journal-title":"Pharm. World Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s40292-021-00465-7","article-title":"Real-world Antihypertensive Treatment Patterns, Treatment Adherence, and Blood Pressure Control in the Elderly: An Italian Awareness-raising Campaign on Hypertension by Senior Italia FederAnziani, the Italian Society of Hypertension and the Italian Federation of General Practitioners","volume":"28","author":"Desideri","year":"2021","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/jhn.13125","article-title":"Effectiveness of dietary interventions delivered by digital health to adults with chronic conditions: Systematic review and meta-analysis","volume":"36","author":"Barnett","year":"2022","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"229","DOI":"10.2165\/00002512-200320030-00006","article-title":"Interventions to improve medication compliance in older patients living in the community: A systematic review of the literature","volume":"20","author":"Tsang","year":"2003","journal-title":"Drugs Aging"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/10\/5878\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:38:26Z","timestamp":1760125106000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/10\/5878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,19]]},"references-count":67,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["ijerph20105878"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20105878","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,19]]}}}