{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:08:29Z","timestamp":1789711709545,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK133465"],"award-info":[{"award-number":["R01DK133465"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005496","name":"American Foundation for Pharmaceutical Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005496","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 RAs) are increasingly used for obesity treatment, but real\u2010world adherence patterns, particularly among individuals without diabetes and paediatric patients, remain poorly characterised. We aimed to identify 12\u2010month GLP\u20101 RA adherence trajectories among adults and paediatric patients with obesity without diabetes and to evaluate factors associated with adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using 2021\u20132023 MarketScan commercial claims data. Individuals aged \u2265\u200910\u2009years with obesity without diabetes who initiated GLP\u20101 RAs were included. Adherence was measured as monthly proportion of days covered (PDC) over 12\u2009months. Group\u2010based trajectory modelling was conducted separately in adult and paediatric cohorts. Multivariable logistic regression was used to identify factors associated with membership in the persistent\u2010user trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 201\u2009229 adults and 1139 paediatric patients. Five adherence trajectories were identified in each cohort. Among adults, trajectories included immediate discontinuers (19.6%), early discontinuers (23.5%), late discontinuers (20.7%), intermittent adherents (5.5%) and persistent users (30.7%), with mean annual PDC ranging from 0.10 to 0.87. Paediatric trajectory groups were more evenly distributed, with each group representing approximately 18%\u201322% of the cohort and persistent users comprising 20.3%. Geographic region was consistently associated with adherence, with higher odds of persistent use in the Northeast versus the South among adults (odds ratio [OR], 1.32) and paediatric patients (OR, 1.65).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most adults and paediatric patients with obesity had suboptimal adherence to GLP\u20101 RA use over 12\u2009months. Distinct adherence trajectories and consistent regional differences highlight opportunities to better understand and address barriers to long\u2010term obesity pharmacotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71299","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:28:48Z","timestamp":1789709328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Adherence Trajectories of\n                    <scp>GLP<\/scp>\n                    \u20101 Receptor Agonists Among Adults and Paediatric Patients With Obesity"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8237-6401","authenticated-orcid":false,"given":"Wenxi","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4864-9662","authenticated-orcid":false,"given":"Pareeta","family":"Kotecha","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E.","family":"Kimmel","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, College of Public Health and Health Professions and College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Segal","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine D.","family":"Gonzalvo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy Purdue University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Marija","family":"Pecoski","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy Purdue University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davene","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Pilgrim Health Care Institute LLC  East Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Melvin and Bren Simon Comprehensive Cancer Center Indiana University  Bloomington Indiana USA"},{"name":"Center for Biomedical Informatics Regenstrief Institute  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9799-2592","authenticated-orcid":false,"given":"Jingchuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes and Policy, College of Pharmacy University of Florida  Gainesville Florida USA"},{"name":"Department of Pharmacy Practice, College of Pharmacy Purdue University  Indianapolis Indiana USA"},{"name":"Center for Biomedical Informatics Regenstrief Institute  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"CDC \u201cAdult Obesity Facts \u201dObesity March 25 2025 https:\/\/www.cdc.gov\/obesity\/adult\u2010obesity\u2010facts\/index.html."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2021.20410"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0247307"},{"key":"e_1_2_10_5_1","unstructured":"CDC \u201cChildhood Obesity Facts \u201dObesity December 20 2024 https:\/\/www.cdc.gov\/obesity\/childhood\u2010obesity\u2010facts\/childhood\u2010obesity\u2010facts.html."},{"key":"e_1_2_10_6_1","unstructured":"Drugs.com \u201cWegovy (Semaglutide) FDA Approval History \u201daccessed September 16 2025 https:\/\/www.drugs.com\/history\/wegovy.html."},{"key":"e_1_2_10_7_1","unstructured":"Drugs.com \u201cSaxenda (Liraglutide) FDA Approval History \u201daccessed September 16 2025 https:\/\/www.drugs.com\/history\/saxenda.html."},{"key":"e_1_2_10_8_1","unstructured":"Drugs.com \u201cZepbound (Tirzepatide) FDA Approval History \u201daccessed September 16 2025 https:\/\/www.drugs.com\/history\/zepbound.html."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2208601"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.3224"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2025.89778"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16318"},{"key":"e_1_2_10_13_1","volume-title":"FDA Clarifies Policies for Compounders as National GLP\u20101 Supply Begins to Stabilize","author":"Center for Drug Evaluation and Research (CDER)","year":"2025"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302773"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.22284"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cppeds.2020.100871"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/children12121716"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/21532176251385715"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.58720"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3182984c1f"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3787"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.09.019"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2018.24.11.1146"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131413"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0049124101029003005"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/978-3-030-51455-6_20","volume-title":"Databases for Pharmacoepidemiological Research","author":"Butler A. M.","year":"2021"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14512"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.03.007"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS\u201024\u201001347"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471\u2010018\u20100176\u20106"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40545\u2010021\u201000385\u2010w"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.57349"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2024.23332"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2026.1272"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201011\u201083"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaa244"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2021.4182"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010023\u201002669\u2010x"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.319811"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71299","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.71299","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.71299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:28:52Z","timestamp":1789709332000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.71299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":39,"alternative-id":["10.1111\/dom.71299"],"URL":"https:\/\/doi.org\/10.1111\/dom.71299","archive":["Portico"],"relation":{},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"assertion":[{"value":"2026-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"dom.71299"}}