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. 2025 May 1:19:1231-1244.
doi: 10.2147/PPA.S509483. eCollection 2025.

Higher Compliance with Treatment Administration Instructions for Injectable Dulaglutide versus Oral Semaglutide Reported by People with Type 2 Diabetes in Clinical Practice Settings in Spain: The TRU-Experience Study

Silvia Díaz-Cerezo  1 , Esther Artime  1 , Jennifer Redondo-Antón  1 , Natalia Duque  1 , Erik Spaepen  2 , Miguel Ángel Mangas Cruz  3 , Claudia Arnas-Leon  4 , Gabriel Olveira  5   6   7   8 , Irene Rodríguez Rodríguez  9 , María Teresa Julián Alagarda  10 , Nuria Valdés  11   12 , Agustín Ángel Merchante  13 , Lluís Masmiquel  9 , Miriam Rubio-de Santos  1
Affiliations

Higher Compliance with Treatment Administration Instructions for Injectable Dulaglutide versus Oral Semaglutide Reported by People with Type 2 Diabetes in Clinical Practice Settings in Spain: The TRU-Experience Study

Silvia Díaz-Cerezo et al. Patient Prefer Adherence. .

Abstract

Purpose: This study compared patient-reported compliance with package leaflet administration instructions of two glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for the treatment of type 2 diabetes (T2D): weekly injectable dulaglutide and daily oral semaglutide.

Patients and methods: This was an observational cross-sectional study conducted in Endocrinology Units in Spain. Patients with T2D receiving weekly injectable dulaglutide or daily oral semaglutide at study enrolment who had initiated treatment 3-12 months before were consecutively recruited during routine visits. Clinical data were extracted from the participants´ medical records. An ad-hoc questionnaire asked how often all and each of the administration instructions specific to each treatment were being followed (eg, timing, steps of intake). Compliance in both groups was calculated using relative and absolute frequencies and matching using the FMA model. The relationship between compliance and sociodemographic/clinical variables was assessed using bivariate analyses. Logistic regression analyses were performed to identify predictors of compliance.

Results: A total of 95 participants treated with weekly injectable dulaglutide and 135 participants treated with daily oral semaglutide were evaluated. More participants treated with weekly injectable dulaglutide (96.8%) than participants treated with daily oral semaglutide (90.4%) were compliant with all package leaflet administration instructions. After adjusting for potential between-group imbalances, higher compliance in the weekly injectable dulaglutide group compared with the daily oral semaglutide group was observed (odds ratio=3.2, 95% confidence interval 1.4-21.3).

Conclusion: Compliance with package leaflet administration instructions was significantly higher in patients with T2D receiving weekly injectable dulaglutide compared to those receiving daily oral semaglutide. This type of real-world compliance data can inform strategies to improve patient education and adherence, and physician prescribing practices, with the goal of ultimately leading to better clinical outcomes and quality of life.

Keywords: endocrinology; glucagon-like peptide 1 receptor agonists; injectable administration; oral administration; real world evidence; treatment adherence.

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Conflict of interest statement

Silvia Díaz-Cerezo, Esther Artime, Jennifer Redondo-Antón, Natalia Duque, and Miriam Rubio-de Santos are employees and minor shareholders of Eli Lilly and Company. Erik Spaepen is a paid consultant for Eli Lilly and Company. Gabriel Olveira reports occasional payment for lectures and attendance at conferences from LILLY, during the conduct of the study. Lluís Masmiquel reports personal fees from Lilly, during the conduct of the study; personal fees from Lilly, outside the submitted work. Authors and/or their institutions have received fees for their participation in the study from Eli Lilly and Company.

Figures

Figure 1
Figure 1
Current GLP-1 RA treatment. Percentage of participants taking the two doses of injectable dulaglutide (0.75 or 1.5 mg; higher doses of dulaglutide are not commercialized in Spain), or three doses of oral semaglutide (3, 7, and 14 mg). Weekly injectable dulaglutide, N=95; daily oral semaglutide, N=135.
Figure 2
Figure 2
Results indicating the proportion of participants taking weekly injectable dulaglutide or daily oral semaglutide who follow treatment administration instructions Table 2.
See this image and copyright information in PMC

References

    1. Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753–2786. doi: 10.2337/dci22-0034 - DOI - PMC - PubMed
    1. Piragine E, Petri D, Martelli A, Calderone V, Lucenteforte E. Adherence to oral antidiabetic drugs in patients with type 2 diabetes: systematic review and meta-analysis. J Clin Med. 2023;12(5):1981. doi: 10.3390/jcm12051981 - DOI - PMC - PubMed
    1. Hamersky CM, Fridman M, Gamble CL, Iyer NN. Injectable antihyperglycemics: a systematic review and critical analysis of the literature on adherence, persistence, and health outcomes. Diabetes Ther. 2019;10(3):865–890. doi: 10.1007/s13300-019-0617-3 - DOI - PMC - PubMed
    1. Boye KS, Mody R, Lage MJ, Douglas S, Patel H. Chronic medication burden and complexity for US patients with type 2 diabetes treated with glucose-lowering agents. Diabetes Ther. 2020;11(7):1513–1525. doi: 10.1007/s13300-020-00838-6 - DOI - PMC - PubMed
    1. Sims TJ, Boye KS, Robinson S, Kennedy-Martin T. Treatment-related attributes of diabetes therapies and how people with type 2 diabetes report their impact on indicators of medication-taking behaviors. Patient Prefer Adherence. 2022;16:1919–1939. doi: 10.2147/PPA.S367046 - DOI - PMC - PubMed

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