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. 2017 Sep 29:10:403-412.
doi: 10.2147/DMSO.S141235. eCollection 2017.

Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes

Mirko V Sikirica  1 , Alan A Martin  2 , Robert Wood  3 , Andrea Leith  3 , James Piercy  3 , Victoria Higgins  3
Affiliations

Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes

Mirko V Sikirica et al. Diabetes Metab Syndr Obes. .

Abstract

Aim: Nonadherence to glucagon-like peptide-1 receptor agonists (GLP1 RAs) is relatively common among patients with type 2 diabetes mellitus (T2DM). This study sought to identify reasons why patients discontinue GLP1 RAs.

Materials and methods: Retrospective data from the Adelphi Diabetes Disease Specific Programme were used. Physicians managing patients with T2DM were surveyed via face-to-face interviews, and patients treated for T2DM were surveyed via self-completed questionnaires. Patient data were stratified by current versus prior GLP1 RA use.

Results: Physicians (n=443) most frequently reported inadequate blood glucose control (45.6%), nausea/vomiting (43.8%), and gastrointestinal (GI) side effects (36.8%) as reasons for GLP1 RA discontinuation. Patients (n=194) reported the GI-related issues "Made me feel sick" (64.4%) and "Made me throw up" (45.4%) as their top reasons for discontinuation. The most common problems reported (excluding cost) for those currently using GLP1 RAs were "Prefer oral medication over injections" (patients 56%, physicians 32.6%), "Made me feel sick" (patients 38.1%, physicians 16.3%), and "Did not help lose weight" (patients 25.4%, physicians 18%). The most bothersome problems for patients globally (frequency reporting very/extremely bothersome) (excluding cost) were "Difficult to plan meals around" (55.6%), "Made me throw up" (51.6%), and "Caused weight gain" (50%).

Conclusion: Both patients and physicians reported GI-related issues as a prominent factor, but disparities between patient experiences and physician perceptions were revealed, suggesting gaps in physician-patient communication. Understanding patients' expectations of GLP1 RAs and physicians' patient-management practices may help increase GLP1 RA adherence and thereby potentially enhance diabetes care.

Keywords: antidiabetic drug; cross-sectional survey; discontinuation; glycemic control; incretin therapy; incretins.

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Figures

Figure 1
Figure 1
Patient-survey cohort (n=2,173). Notes: Bases for each analysis differ based on the number of responses for question. Abbreviations: GLP1 RA, glucagon-like peptide-1 receptor agonist; T2DM, type 2 diabetes mellitus.
Figure 2
Figure 2
Reasons for GLP1 RA discontinuation in the past 6 months, ranked by frequency. Notes: (A) Physicians (n=443); (B) patients (n=194). Abbreviations: GI, gastrointestinal; GLP1 RA, glucagon-like peptide-1 receptor agonist.
Figure 3
Figure 3
Problems reported with GLP1 RA treatment. Notes: *GI-related issues. Physician-estimated versus patient-reported prevalence of each problem among patients currently using GLP1 RAs. (A) Global results; (B) EU5 results (France, Germany, Italy, Spain, and the UK); (C) US results; (D) global results, proportion of patients reporting problems as very or extremely bothersome. Exact questions listed in Table S1. Abbreviations: GI, gastrointestinal; GLP1 RA, glucagon-like peptide-1 receptor agonist.
Figure 3
Figure 3
Problems reported with GLP1 RA treatment. Notes: *GI-related issues. Physician-estimated versus patient-reported prevalence of each problem among patients currently using GLP1 RAs. (A) Global results; (B) EU5 results (France, Germany, Italy, Spain, and the UK); (C) US results; (D) global results, proportion of patients reporting problems as very or extremely bothersome. Exact questions listed in Table S1. Abbreviations: GI, gastrointestinal; GLP1 RA, glucagon-like peptide-1 receptor agonist.
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