Comparison of patients achieving treatment success with a glucagon-like peptide-1 receptor agonist for weight management between primary care provider and pharmacist co-managed patients

Abstract

Introduction: Glucagon-like peptide-1 receptor (GLP-1) agonists have great efficacy for weight management; however, treatment success rates with an ambulatory clinical pharmacist co-managing these agents have yet to be well established. Objective: To compare the difference in reaching treatment success for weight management on GLP-1 agonist therapy between patients in the primary care setting co-managed by their primary care provider (PCP) and embedded ambulatory clinical pharmacists, compared with those managed by their PCP alone. Methods: This was a retrospective cohort study that evaluated adult patients prescribed either the GLP-1 agonist liraglutide or semaglutide for weight management between October 1, 2021, and August 14, 2023. The two cohorts compared the pharmacist co-managed group versus standard stand-alone PCP management. Patients were evaluated for treatment success by losing 5% or more of their total body weight 12 weeks after achieving their maximally tolerated dose of GLP-1 agonist therapy. Results: A total of 161 patients were included (PCP alone, n = 81; pharmacist co-management, n = 80). More patients in the pharmacist co-managed group achieved treatment success (82.5% vs. 33.3%, p < 0.001) and lost a higher percentage of body weight at 6–8 months (9.6% vs. 6.3%, p < 0.001). Documentation of treatment success was not complete in 59.3% of patients in the PCP alone group and 10% of patients in the pharmacist co-managed group; a significant difference in treatment success rates between groups was not observed between the pharmacist co-managed group and PCP alone groups after removing undocumented cases (91.7% vs. 81.8%, p = 0.187) More patients lost 5%–14.9% of their body weight in the pharmacist co-managed group. Conclusion: For patients treated with a GLP-1 agonist for weight management, pharmacist co-management led to higher rates of documented treatment success. However, the results are limited by a large proportion of undocumented outcomes in the PCP alone group.