How You Can Prevent GLP-1 Dropout

Most of the time, people don’t stop taking GLP-1s because the medication isn’t working or they’re not seeing results. They stop because nobody prepared them for the side effects.

As healthcare professionals, it’s important to stop assuming adherence is mainly about motivation. Usually it's about hassle. Here are three things you can do immediately to help your patients deal with side effects and stay the course. 

1. Set realistic expectations

Patients find more success with GLP-1s when they can anticipate the challenges of therapy. Healthcare professionals can help by setting expectations early. This means discussing:

• How much weight they can expect to lose

• What side effects they can expect

• What they can do to manage side effects

• How long side effects last

Telling patients side effects are expected and temporary can help normalize their experience.

2. Pre-treat predictable barriers

Since most GLP-1 side effects are predictable, you can help identify barriers before they happen and make a plan to address them. 

For instance, it’s helpful to come up with plans for:

• Nausea management

• Diarrhea and constipation

• Hydration

• Meals and protein intake

Schedule a check-in with your patient in the first few weeks of treatment — when issues tend to arise — to talk over their experience. This not only gives them the chance to voice concerns about any unexpected issues, but also allows you to celebrate your patient’s wins and validate their efforts.

3. Build dose flexibility into their plan

Dose flexibility might not come naturally for a lot of prescribers, since it isn’t spelled out in the drug information. But allowing for flexibility can translate into long-term success for patients.

If a patient is responding well to a lower dose, there’s no reason for rapid escalation. Pausing escalation also makes sense if a patient is experiencing significant side effects.

Patients shouldn’t feel like titration is a test that they can fail. So empower your patients to escalate more slowly, stay on a lower dose, or go back down to a lower dose from a higher one. Flexibility helps ensure that one difficult week doesn’t mean the end of effective therapy. 

The best dose is the dose a patient can stay on.