Statin adherence is often limited by side effects. The SLCO1B1*5 variant is a 
risk factor for statin side effects and exhibits statin-specific effects: 
highest with simvastatin/atorvastatin and lowest with pravastatin/rosuvastatin. 
The effects of SLCO1B1*5 genotype guided statin therapy (GGST) are unknown. 
Primary care patients (n = 58) who were nonadherent to statins and their 
providers received SLCO1B1*5 genotyping and guided recommendations via the 
electronic medical record (EMR). The primary outcome was the change in Beliefs 
about Medications Questionnaire, which measured patients' perceived needs for 
statins and concerns about adverse effects, measured before and after SLCO1B1*5 
results. Concurrent controls (n = 59) were identified through the EMR to compare 
secondary outcomes: new statin prescriptions, statin utilization, and change in 
LDL-cholesterol (LDL-c). GGST patients had trends (p = 0.2) towards improved 
statin necessity and concerns. The largest changes were the "need for statin to 
prevent sickness" (p < 0.001) and "concern for statin to disrupt life" (p = 
0.006). GGST patients had more statin prescriptions (p < 0.001), higher statin 
use (p < 0.001), and greater decrease in LDL-c (p = 0.059) during follow-up. EMR 
delivery of SLCO1B1*5 results and recommendations is feasible in the primary 
care setting. This novel intervention may improve patients' perceptions of 
statins and physician behaviors that promote higher statin adherence and lower 
LDL-c.