Presentation (CTI)

OBJECTIVES: Real-world persistence with SGLT2 inhibitors and GLP-1 receptor agonists remains suboptimal among patients with type 2 diabetes, underscoring the need to understand healthcare provider-perceived reasons for discontinuation. This qualitative study was conducted to explore the key reasons for discontinuation of SGLT2 inhibitors and GLP-1 receptor agonists from the perspective of healthcare providers.
METHODS: Semi-structured interviews were conducted with 15 healthcare providers (HCPs), including primary care physicians (PCPs)/endocrinologists and clinical pharmacists who have experience prescribing SGLT2is and GLP1-RA for patients with type 2 diabetes (T2D). Interviews were transcribed verbatim and analyzed using a thematic content analysis approach.
RESULTS: Across all PCPs/endocrinologists (n=8) and clinical pharmacists (n=7), cost was mentioned as the most common reason for discontinuation of therapy. Side effects and tolerability issues were identified as the second most common reason (6/7 pharmacists; 7/8 physicians), primarily due to gastrointestinal side effects associated with GLP-1 RA and genitourinary tract infections with SGLT2-i. Approximately one-third of HCPs (5/15) noted that patients often discontinue therapy due to plateau in weight loss effect for both drugs. Main facilitators identified for SGLT2-i and GLP-1 RA prescribing included cardiovascular benefits (15/15), weight loss effect (15/15) and A1c improvement (13/15) reported consistently by all providers.
CONCLUSIONS: Findings of the study underscore the importance of addressing affordability issues and setting expectations for potential side effects to facilitate better management, ultimately leading to improved adherence and subsequent long-term outcomes in T2D patients.