(089) Characteristics of Glucagon-Like Peptide-1 Agonist Prescriptions for Weight Loss in the Real-World Setting

Background: Glucagon-like peptide-1 (GLP-1) agonists are treatments that can help manage blood glucose in type 2 diabetes (T2D) patients and can also be used for weight loss. Characteristics of GLP-1 agonist prescriptions for weight loss in the real-world setting are not well understood.

Objectives: To describe real-world patient, clinician, and facility characteristics associated with prescriptions of GLP-1 receptor agonists for weight loss in United States-based health networks.

Methods: Electronic health record data (2017-2024) from 12 health networks in the OMNY Health real-world data platform was accessed. Patients with at least 1 prescription order for a GLP-1 receptor agonist for weight loss (liraglutide, semaglutide, or tirzepatide) were selected. Patients with nonmissing data were indexed at first GLP-1 agonist prescription and characterized with respect to demographics, diagnoses, and prescriptions of other therapies at the same visit. Prescribing clinician taxonomy and facility characteristics were summarized.

Results: Among over 20 million patients from these health networks, a total of 173,494 patients had prescriptions for either liraglutide, semaglutide or tirzepatide. Distributions of gender (68% female), race (21% nonwhite), ethnicity (7% Hispanic or Latino), age (mean: 54 years), marital status (60% married), and employment status (13% unemployed) were similar between GLP-1 agonist groups. Per body mass index (BMI) categories, 84% and 13% of patients were obese and overweight, respectively. Most prevalent diagnosis codes at index were T2D (34%), obesity (29%), hypertension (22%), hyperlipidemia (20%), high body mass index (17%), chronic insulin use (10%), elevated blood glucose (7%), screening for malignant cancer (7%). Commonly prescribed cotherapies were statins (13%), insulin (9%), angiotensin converting enzyme inhibitors (8%), metformin (7%), calcium channel blockers (6%), levothyroxine (5%), and ondansetron (5%). GLP-1 agonist prescriptions were most prevalent in the family medicine setting (36%/46%/51% liraglutide/semaglutide/tirzepatide) followed by internal medicine (22%), endocrinology (13%), primary care (7%), and surgery (4%). Most common prescribing clinician taxonomies were internal medicine (30%), family medicine (29%), nurse practitioner (28%), physician assistant (6%) and resident/intern (4%).

Conclusions: Results provide insights into GLP-1 agonist prescriptions in the real-world setting. Patient, clinician, and facility characteristics were largely similar among individual GLP-1 treatments. Future analyses may follow patients over time to assess real-world comparative effectiveness.