Medication Adherence to Semaglutide Once-Weekly Injection Among Type-2 Diabetes Patients in Tabuk, Saudi Arabia – A Cross-Sectional Study

Palanisamy Amirthalingam,1 Olayan Salamah Alatawi,2 Ahmed Mohsen Elsaid Hamdan,1 Ahmed Aljabri,3 Saleh Alqifari,1 Hanan Alshareef,1 Faris Ahmed M Hakami,2 Nader Salem Albalawi,2 Hazem Moufeed A Albrahimi,4 Sultan Mohammed Mubark Alanazi,4 Ahmed Mutair Alatawi,4 Abdullah Abdalziz S Albalwi,4 Mostafa A Sayed Ali1 1Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia; 2King Salman Armed Forces Hospital, Northwestern Region, Tabuk, Saudi Arabia; 3Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; 4Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi ArabiaCorrespondence: Palanisamy Amirthalingam, Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, P.O. Box 741, Tabuk, 71491, Saudi Arabia, Email [email protected]: Semaglutide, a once-weekly injection (SOWI), is a glucagon-like peptide-1 receptor agonist for managing type-2 diabetes (T2D). However, it has a high discontinuation rate among users in the first year after treatment initiation. This study investigated the medication adherence level among T2D patients managed with SOWI.Methods: This cross-sectional study was conducted among T2D patients aged 18 years or above who visited the outpatient pharmacy to refill their prescriptions for SOWI. The patients responded to their sociodemographic characteristics and the Adherence to Refills and Medications Scale (ARMS). The patient’s electronic health record obtained details of the proportion of days covered (PDC), glycosylated hemoglobin (HbA1C), and body mass index (BMI). The association of medication adherence and sociodemographic characteristics, as well as the clinical outcomes between patients with different levels of adherence, were analyzed.Results: A total of 434 patients were included in this study. According to the ARMS score, only 32.48% (141) of the patients adhered to SOWI. Sociodemographic characteristics had lower odds association for medication non-adherence. However, non-adherent patients had a significant association with BMI (overweight and obese) and HbA1C (> 7). The adherence level of PDC for SOWI was significantly associated with the ARMS medication adherence level. The mean HbA1C and BMI between adherents and non-adherents were statistically significant (p< 0.001). The patients who adhered to both ARMS and PDC (n = 126) experienced a significant decline in mean BMI (p < 0.001) and HbA1C (p < 0.001) compared to patients who adhered to PDC but not ARMS and those who did not adhere to either ARMS or PDC.Conclusion: Medication adherence to the SOWI is subjective to T2D patients and not influenced by sociodemographic characteristics. T2D patients need more motivation to refill and administer the SOWI according to the schedule since medication adherence directly impacts HbA1C and BMI.Keywords: adherence to refills and medications scale, body mass index, glycosylated hemoglobin, medication adherence, proportion to days covered, semaglutide, type-2 diabetes