Pharmacists can improve statin adherence and refine triglyceride management by leveraging patient-centered counseling, adherence strategies, and updated guideline recommendations prioritizing statins and targeted adjunctive therapies.
In an interview with Pharmacy Times, Joel C. Marrs, PharmD, MPH, BCACP, BCCP, BCPS, a cardiology ambulatory clinical pharmacist at Cheyenne Regional Medical Group Heart and Vascular Institute in Wyoming and adjoint associate professor at the University of Colorado School of Medicine in Denver, discussed evidence-based strategies pharmacists can use to address statin-associated muscle symptoms and optimize triglyceride management.
Marrs emphasized that although approximately 10% of patients in real-world settings report muscle-related adverse effects, statins remain the foundational therapy for lowering atherosclerotic cardiovascular disease (ASCVD) risk. Pharmacists play a critical role in counseling patients on the balance between benefits and potential adverse effects, maintaining transparency without discouraging adherence.
To improve statin persistence, Marrs highlighted practical interventions such as exploring alternative dosing strategies, tailoring therapy based on individual risk profiles, and addressing adherence barriers. Synchronizing medication refills, prescribing 90-day supplies, and proactively discussing cost-related concerns can significantly enhance continuity of therapy. These pharmacist-led interventions are essential, as maintaining patients on statin therapy remains the most impactful strategy for cardiovascular risk reduction.
“About 10% of patients report muscle symptoms, but our goal is to work with them to keep statins on board, because they remain the primary workhorse for lowering cardiovascular risk.” – Joel C. Marrs, PharmD, MPH, BCACP, BCCP, BCPS
Regarding triglyceride management, Marrs outlined notable updates in the 2026 guidelines, including a reduced emphasis on fibrates and omega-3 fatty acids relative to statins. Pharmacologic triglyceride-lowering therapies are now more clearly reserved for patients with significantly elevated triglycerides, particularly 500 mg/dL or higher and especially 1000 mg/dL or higher, where the primary goal shifts to pancreatitis prevention. Icosapent ethyl (Vascepa; Amarin Pharmaceuticals) retains a role in select high-risk populations, including patients with established ASCVD or diabetes with additional risk factors, due to its demonstrated cardiovascular benefit.
Additionally, Marrs noted emerging therapies such as olezarsen (Tryngolza; Ionis Pharmaceuticals) for familial chylomicronemia syndrome, signaling continued evolution in treatment options. Overall, pharmacists are integral in aligning guideline-directed therapy with patient-specific needs while reinforcing adherence and optimizing outcomes.
