{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:00:18Z","timestamp":1785124818158,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Reviews"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glucagon\u2010like peptide 1 (GLP\u20101) agonists are widely used for obesity management in patients with or without diabetes. However, treatment persistence is often limited due to adverse drug reactions (ADRs). Understanding adherence patterns in randomized controlled trials (RCTs) is crucial for predicting real\u2010world treatment acceptance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the pooled nonadherence rates and reasons for nonadherence to GLP\u20101 agonists in overweight or patients with obesity participating in RCTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review and meta\u2010analysis of RCTs was conducted to evaluate nonadherence to GLP\u20101 receptor agonists. A literature search was performed in PubMed, Embase, and Web of Science from inception to October 2, 2024. Studies were included if they evaluated GLP\u20101 receptor agonists for overweight or obesity management and reported adherence outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The pooled RR for nonadherence to GLP\u20101 receptor agonists was 0.63 (95% CI: 0.48, 0.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), indicating a 37% lower risk of nonadherence compared with the control group. However, ADR\u2010induced nonadherence was significantly higher in the GLP\u20101 group (RR: 2.29 [95% CI: 1.47, 3.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04]), particularly due to gastrointestinal side effects. Nonadherence due to loss to follow\u2010up was lower in the GLP\u20101 group (RR: 0.43 [95% CI: 0.27, 0.71,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.18]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GLP\u20101 receptor agonists were associated with a lower overall nonadherence rate in RCTs compared with control treatments, suggesting higher persistence. However, ADR\u2010related nonadherence was significantly higher, particularly due to gastrointestinal side effects. These findings highlight the need for strategies to improve treatment tolerability and adherence in real\u2010world settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/obr.70200","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T03:10:43Z","timestamp":1785121843000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonadherence to GLP\u20101 Receptor Agonists Among Individuals With Overweight or Obesity: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0096-7516","authenticated-orcid":false,"given":"Efrata A.","family":"Shegena","sequence":"first","affiliation":[{"name":"Division of Pharmaceutical Evaluation and Policy, College of Pharmacy University of Arkansas for Medical Sciences  Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekdes","family":"Kiflu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Debre Markos University  Debre Markos Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9524-7027","authenticated-orcid":false,"given":"Muktar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0581-7808","authenticated-orcid":false,"given":"Akshaya Srikanth","family":"Bhagavathula","sequence":"additional","affiliation":[{"name":"Public Health Program, School of Health Systems &amp; Innovation, College of Health and Human Sciences North Dakota State University  Fargo North Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadesse M.","family":"Abegaz","sequence":"additional","affiliation":[{"name":"School of Pharmacy The University of Texas  El Paso Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Center for Control Disease.Obesity and Over WeightMarch 6 2026. 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