Ash Wellness does not give medical advice. Patients should reach out to their provider for more information on GLP-1s. 

Navigating the complexities of medication adherence is crucial, especially when it comes to GLP-1s—the key players in type 2 diabetes treatment. Providers wrote more than 9 million prescriptions for Ozempic and similar drugs in the last three months of 2022 alone. In this blog post, we explore actionable tips and insights on how providers can help patients keep to their prescribed GLP-1 regimen.

What are GLP-1s?

GLP-1s, or glucagon-like peptide-1 receptor agonists, are medications used to treat type 2 diabetes. They mimic the effects of the natural hormone GLP-1, stimulating insulin release, reducing glucagon secretion, and slowing gastric emptying. This helps regulate blood sugar levels. GLP-1s are administered via injection or through oral tablets and are known for their weight-loss benefits. 

Some of these medications include:

• Dulaglutide 
• Exenatide extended release 
• Exenatide 
• Semaglutide 
• Liraglutide 
• Lixisenatide 
• Semaglutide 

What is medication adherence?

Medication adherence refers to the extent to which individuals follow prescribed medication regimens, including dosage, timing, and frequency. It is crucial for effective treatment outcomes in managing various health conditions. Adhering to medication guidelines as directed by health care providers ensures that patients receive the intended benefits, optimizing the chances of successful treatment and minimizing risks associated with non-compliance. 

Medication adherence can also include routine lab testing. For example, patients prescribed the HIV prevention drug PrEP must complete routine lab screening for HIV, creatinine levels, and sometimes additional STIs such as HBV, gonorrhea, and chlamydia. Routine lab testing can be a barrier to care for some patients who cannot take off work or arrange transportation to visit an in-person clinic or phlebotomist. 

How long do patients stay on GLP-1s?

Some studies suggest that GLP-1 drugs can lead to between 10.5 to 15.8 pounds of weight loss, while lifestyle changes can boost that number to 33.7 pounds. 64.7% of patients discontinue injectable GLP-1 therapy within 24 months, according to one study. Almost half of those patients discontinued GLP-1 RA therapy within 12 months. 

How can providers manage medication adherence for GLP-1s?

Medication adherence for GLP-1s may include consistency to the prescribed dosage, timing, and frequency of GLP-1s. Studies suggest that overall adherence is crucial to sustained weight loss on GLP-1s. There are no current federal testing requirements for GLP-1 medication adherence, but providers can track patient progress with a variety of diagnostic lab tests. 

Can providers manage remote medication adherence for GLP-1s?

Providers can use remote diagnostics to track patient reactions to GLP-1s. This can also help provide a framework for providers to wean patients off GLP-1s after health targets are reached, which may reduce overall costs. 

At-home lab tests may include:

• BUN 
• Creatinine 
• Total Cholesterol
• HDL Cholesterol 
• Triglycerides 
• TSH 
• HbA1c

These remote tests would require the use of dried blood spot cards. Dried blood spot testing involves patients collecting capillary blood through a finger prick and blotting a special filter paper on a test card. After the blood sample dries, patients mail it to a laboratory where a technician extracts the targeted analytes. Collection kits often include a dried blood spot collection card, alcohol pads, gauze pads, single-use lancets, bandages, and a return pouch. This testing method is applicable for screening HIV, Hepatitis B and C, syphilis, and other blood-borne diseases. 

How does remote medication adherence work? 

At-home diagnostic testing enables patients to self-collect samples for lab diagnostics in the comfort of their homes. Patients receive a collection kit containing necessary tools, instructions, and sample collection materials. They collect samples (e.g., blood, saliva, urine), follow provided guidelines, and send samples back to a laboratory for analysis. Results are then delivered electronically or through a secure platform. This approach enhances accessibility to health care services, especially during remote or challenging circumstances.

Ash Wellness has the largest remote medication adherence program in the United States

Ash Wellness supports the largest use case for pre-exposure prophylaxis (PrEP) prescription and adherence in the United States, processing over 10,000 HIV and creatinine test kits per month. Remote medication adherence through Ash Wellness helps break down barriers to care for low-income patients and others who cannot routinely visit an in-person phlebotomist for lab testing. 

We offer the ability for providers and organizations to choose white-labeled kitting to reach patients for ongoing medication adherence through remote testing. Our clients can create a custom kit tray insert or postcard to showcase their brand and guide patients to get started. There is opportunity to include components such as logo and other branding, high-level instructions for completing the kit, contact and support lines, and QR code or link to instructional videos, and other resources such as general health and wellness education pertaining to the collection kit content. Clients also have the opportunity to include their preferred resources and content in the secure Patient Portal.