Evidence for Change: Adherence & Persistence to GLP-1 Therapies

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Evidence for Change: Adherence & Persistence to GLP-1 Therapies

Evidence for Change

In our Evidence for Change series, we provide a brief overview of key behavioral science research that Atlantis Health applies in supporting patients living with long-term conditions to achieve optimal health outcomes and Change for Good.

Research selected

"Real-world persistence and adherence to glucagon-like peptide-1 receptor agonists among obese commercially insured adults without diabetes" Gleason, P. P., Urick, B. Y., Marshall, L. Z., Friedlander, N., Qiu, Y., & Leslie, R. S. (2024). Journal of Managed Care and Specialty Pharmacy, 30(8), 860-867.

Relevance today

Challenge: GLP-1 therapies have revolutionized treatment of obesity by enabling clinically significant and sustained weight loss through biological appetite regulation rather than lifestyle changes and willpower alone. These medications reduce serious obesity-related complications and have changed the medical paradigm from viewing obesity as a lifestyle choice to treating it as a chronic biological disease.

GLP-1 therapies help to correct the body's natural resistance to weight loss while potentially preventing progression to type 2 diabetes and improving patients' quality of life.

Adherence to GLP-1 therapy is vital for people living with obesity since ongoing weight loss and heart health benefits disappear when treatment is discontinued. Most patients tend to regain substantial weight when they stop treatment.

Common challenges to GLP-1 therapy adherence include gastrointestinal side effects, self-injection requirements, and the need to accept long-term treatment through medication. Addressing these barriers through side effect management and patient education is essential since the value and impact of these medications depends entirely on sustained use.

What the research tells us

The authors examined adherence and persistence to GLP-1 therapy among people living with obesity and without diabetes by analyzing pharmacy and medical claims data.

From 16.5 million commercially-insured individuals, they identified those who:

Started treatment in 2021
Were 19 years or older
Were continuously enrolled in the insurance program 1 year prior and after their GLP-1 therapy start date

Persistence was defined as no gaps in treatment greater than or equal to 60 days and adherence was defined as greater than or equal to 80% of the proportion of days covered during the 1-year assessment. The authors also tracked product switching patterns among these patients.

Of the 4,066 identified individuals (mean age = 46 years; 81% female), only 32.3% of people remained on their GLP-1 therapy across the 1-year period and only 27.2% were adherent to the GLP-1 therapy as prescribed by their doctor. Average proportion of days covered during the 1-year assessment was 51%.

Persistence and adherence rates varied significantly between different GLP-1 therapies, with semaglutide (Ozempic) showing the highest persistence (47.1%) and liraglutide (Saxenda) the lowest (19.2%). Additionally, they found 11.1% of members switched between GLP-1 therapies during the first year of therapy. 

These real-world findings highlight the need for effective and personalized patient support for GLP-1 therapy in order for those living with obesity to realize the full benefit of treatment.

Value from these products may be obtained through reductions in obesity complications ... but this value is not likely to be realized if treatment is discontinued during the first year and weight loss is not achieved or maintained.

Applying the research

At Atlantis Health, we have international experience in supporting patients on their weight management journey utilizing behavioral science and health psychology to assist people adhere to treatment and adopt long term healthy behaviors.

Working with pharmaceutical companies, biotech and healthcare organizations, we improve patient experiences and outcomes.

Read more about our services and our co-designed digital health solutions.

Adherence & Persistence to GLP-1 Therapies