Exploring Why People With Type 2 Diabetes Do or Do Not Persist With Glucagon-Like Peptide-1 Receptor Agonist Therapy: A Qualitative Study

Abstract

OBJECTIVE | Despite the demonstrated benefits of glucagon-like peptide 1 (GLP-1) receptor agonist therapy, adherence and persistence with this therapy is often challenging. The purpose of this study was to expand current understanding of patients' experiences, motivations, and challenges relevant to their persistence with GLP-1 receptor agonist therapy.

‘For me, it didn’t seem as drastic a step as being controlled by insulin’: A qualitative investigation of expectations and experiences of non‐insulin injectable therapy among adults with type 2 diabetes

“…Consistent with prior findings, 14,29 potential for weightloss and glucose reduction were reportedly drivers of GLP-1RA uptake / ongoing use, and (if realised) described as outweighing concerns about injectable treatment. Participants used emotive language (e.g.…”

“…However, limited qualitative studies have explored potential psychological barriers to injectable GLP-1RAs. 14 Research to date has largely used structured, pre-defined questions with fixed response options (e.g. questionnaires, discrete choice experiments) that provided no opportunity to elicit unknown barriers to, or experience with, injectable GLP-1RA treatment.…”

“…One, recently published, interview study explored primary reasons for continuation or discontinuation of injectable GLP-1RA among 36 American adults. 14 However, the largely quantitative data presented focuses on common facilitators and challenges of treatment, drawing on responses to a pre-determined list and open-ended questioning, rather than providing a rich narrative of the beliefs, attitudes and experiences of participants. Therefore, the aim of this study was to undertake an in-depth exploration of the expectations and experiences of adults with T2D regarding GLP-1RA use, and (dis)continuation, as well as attitudes toward further injectable treatment intensification.…”

“…[6][7][8] Quantitative research has identified (perceived or experienced) favourable treatment attributes, including treatment efficacy, potential for weight loss, lack of associated hypoglycaemic episodes and convenience. [9][10][11][12][13][14] While the most common reasons for discontinuing injectable GLP-1RA are a perceived lack of need, preference for oral medications, adverse gastrointestinal events, and lack of efficacy. [14][15][16] In contrast, a study of UK physicians identified 'patient fear of insulin' as a reason for GLP-1RA prescription.…”

“…[9][10][11][12][13][14] While the most common reasons for discontinuing injectable GLP-1RA are a perceived lack of need, preference for oral medications, adverse gastrointestinal events, and lack of efficacy. [14][15][16] In contrast, a study of UK physicians identified 'patient fear of insulin' as a reason for GLP-1RA prescription. 13 A large discrete choice experiment study among adults with T2D (N = 875; 58% non-insulin treated) identified a preference for either once-weekly or once-daily injectable GLP-1RA treatment over insulin therapy.…”