Short Supply, Long-Term Effects: Evaluating Diabetic Patient Adherence Amidst the Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Shortage

Abstract

Specific Aims: To evaluate the effects of the ongoing glucagon-like peptide-1 (GLP-1) receptor agonist shortage on medication adherence among type 2 diabetes patients at Banner University Medical Center – Phoenix Internal Medicine Clinic. Methods: A retrospective cohort study was conducted utilizing electronic health record data from Banner University Medical Center – Phoenix Internal Medicine Clinic. Patients included were adults diagnosed with T2DM prescribed a GLP-1 receptor agonist prior to and during the shortage period (January 1, 2022 to December 31, 2023). Medication adherence was determined by reviewing patient EHRs and evaluating medication refill claims history. Changes in HbA1c and BMI were analyzed based on prescriber interventions, dose decrease or no intervention. Statistical analyses involved paired t-tests, with significance set at p<0.05. Results: A total of 31 patients (mean age 57.4 years; 61.3% female; 71% White) were included. The decreased dose group (n=15) demonstrated a statistically significant increase in HbA1c of 0.51%, whereas the no intervention group (n=16) showed a non-significant increase of 0.3%. Changes in BMI were not statistically significant in either group, with increases of 0.4 kg/m² and 0.09 kg/m² respectively. Conclusions: The GLP-1 receptor agonist shortage significantly reduced medication adherence and adversely affected glycemic control. While the type of prescriber intervention influenced changes in HbA1c, BMI was not significantly impacted, underscoring the need for individualized clinical strategies during medication shortages.