Patient Adherence to Anti-Obesity Medications

Patient Adherence to Anti-Obesity Medications

August 31, 2023

August 2023 Letter from the Director

New anti-obesity medications (AOMs), like semaglutide, have proven effective in helping individuals lose weight. Now, research soon to be published has shown promising efficacy in reducing adverse cardiovascular outcomes. As insurance companies struggle with how and whether to cover AOMs, it is important to consider how patients will adhere to taking them to ensure positive health outcomes.
Because semaglutide, a glucagon-like-peptide-1 agonist (GLP-1) medication that helps people feel fuller sooner and suppresses appetite is new, only limited information is available regarding how well patients adhere to the once-weekly injection schedule. Long-term adherence to AOMs is essential because relapse occurs when patients discontinue treatment. An analysis by Prime Therapeutics examined pharmaceutical claims data and found that 68% of individuals who started GLP-1 medication treatment had stopped within one year. The analysis did not consider why patients stopped taking the treatment; reasons could include medication side effects, lack of affordability, cost, or discontinuation of their insurance coverage. Further research is essential to understand why non-adherence occurs and how to rectify it.
Medication non-adherence is not unique to anti-obesity medications. When GLP-1 medications are used in type 2 diabetes treatment, one study found that only 50.9% of patients continued their medication at 12 months and 47.4% at 24 months. No data were provided as to why patients discontinued treatment. Equally concerning trends of medication non-adherence have been observed with antihypertensive medications. Research has shown an overall non-adherence rate of 31% for antihypertensives nationally, despite the importance of remaining normotensive to avoid serious cardiovascular health outcomes. Similarly, only about 51% of patients with cancer adhere to their oral anticancer medication regimen. Researchers in this cancer medication study noted several factors, including patient demographics, out-of-pocket costs, and clinical characteristics that can impact patient adherence to medications.
scoping review of prescription medication adherence in chronic disease treatment research has revealed six key areas where patients may experience barriers to adherence: 

  • Patient-specific barriers: change in routines, stress, lack of health literacy

  • Illness-specific barriers: disease not a priority, lack of symptoms

  • Medication-specific barriers: lack of information or trust, complexity

  • Healthcare system barriers: communication with providers, lack of support

  • Social and cultural barriers: stigma, religion, lack of social support group

  • Logistical and financial barriers: cost, shortages

The same review also highlighted key areas that facilitate patient medication adherence which can be targets for interventions to improve adherence and patient health outcomes. These are shown in the figure below.

Source: Adapted from Kvarnström, et al.
Medication adherence is essential for patients to experience better health outcomes, including the effective and long-term treatment of obesity. Adherence is also important when it comes to understanding the impact on our healthcare system. Fostering improved medication adherence through patient counseling and education should be a priority for providers to ensure that patients have the tools they need to achieve better health outcomes.

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