Real-World Drivers of Adherence in Obesity Highlight the Need for Patient-Centered Interventions
Author(s)
Victoria Higgins, BA (Hons)1, Mark Duman, BSc (Hons)2, Andrea Leith, BSc (Hons)3, James PIKE, M.Phil. in Statistics3, Sophie Barlow, MSc3.
1Director, Adelphi Real World, Bollington, United Kingdom, 2MD Healthcare, Salford, United Kingdom, 3Adelphi Real World, Bollington, United Kingdom.
1Director, Adelphi Real World, Bollington, United Kingdom, 2MD Healthcare, Salford, United Kingdom, 3Adelphi Real World, Bollington, United Kingdom.
Presentation Documents
OBJECTIVES: Obesity is a complex, chronic condition requiring sustained lifestyle changes and, in many cases, pharmacological and/or surgical interventions. Despite the availability of effective treatments, adherence to these lifestyle changes and/or treatment regimens remains a key determinant of real-world outcomes. This analysis aimed to identify drivers of adherence in people living with obesity (PLwO).
METHODS: Data were drawn from the Adelphi Real World Obesity Disease Specific Programme™, a cross-sectional survey of physicians and PLwO conducted in 5EU, US, and Australia between October 2023 and April 2024. Physicians confirmed obesity status, and PLwO self-reported adherence using the 11-item Adelphi Adherence Questionnaire© (ADAQ; 0=adherent, 4=not adherent). Additional PLwO-reported data included lifestyle behaviours, medication experiences, and information sources. Elastic net regression with 10-fold cross-validation was used to determine which participant characteristics were predictive of ADAQ. P-values were derived through bootstrapping.
RESULTS: 201 physicians reported on 411 PLwO (mean age 50.1 years; 63.7% female; mean BMI 35.2 kg/m²; mean ADAQ 0.43). Significant predictors of increased adherence included use of prescription medication (p=0.030), while stopping medication due to not losing enough weight (p=0.004) or cost (p=0.041) were associated with decreased adherence. Predictors selected by the elastic net that demonstrated only marginal significance in the bootstrap (0.05<p<0.1) included stopping medication due to side effects (p=0.075) and experiencing reduced physical discomfort with weight loss (p=0.064).
CONCLUSIONS: Elastic net regression identified cost and perceived inefficacy around weight loss as key drivers to non-adherence in PLwO, while prescription-based interventions were paradoxically associated with improved adherence. While medication experiences emerged as key predictors of adherence, lifestyle behaviours and information sources showed limited influence, with only marginal associations observed. These findings highlight the importance of patient-centred strategies that address both economic and factors important to PLwOs for their obesity care. Systematic adherence assessment in clinical practice may support more tailored and effective interventions.
METHODS: Data were drawn from the Adelphi Real World Obesity Disease Specific Programme™, a cross-sectional survey of physicians and PLwO conducted in 5EU, US, and Australia between October 2023 and April 2024. Physicians confirmed obesity status, and PLwO self-reported adherence using the 11-item Adelphi Adherence Questionnaire© (ADAQ; 0=adherent, 4=not adherent). Additional PLwO-reported data included lifestyle behaviours, medication experiences, and information sources. Elastic net regression with 10-fold cross-validation was used to determine which participant characteristics were predictive of ADAQ. P-values were derived through bootstrapping.
RESULTS: 201 physicians reported on 411 PLwO (mean age 50.1 years; 63.7% female; mean BMI 35.2 kg/m²; mean ADAQ 0.43). Significant predictors of increased adherence included use of prescription medication (p=0.030), while stopping medication due to not losing enough weight (p=0.004) or cost (p=0.041) were associated with decreased adherence. Predictors selected by the elastic net that demonstrated only marginal significance in the bootstrap (0.05<p<0.1) included stopping medication due to side effects (p=0.075) and experiencing reduced physical discomfort with weight loss (p=0.064).
CONCLUSIONS: Elastic net regression identified cost and perceived inefficacy around weight loss as key drivers to non-adherence in PLwO, while prescription-based interventions were paradoxically associated with improved adherence. While medication experiences emerged as key predictors of adherence, lifestyle behaviours and information sources showed limited influence, with only marginal associations observed. These findings highlight the importance of patient-centred strategies that address both economic and factors important to PLwOs for their obesity care. Systematic adherence assessment in clinical practice may support more tailored and effective interventions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR205
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas