Analysis of Prescribing Patterns of Incretin-Based Therapies in Patients with Type 2 Diabetes in a Primary Care Clinic

Abstract

Purpose: The purpose of this study was to evaluate the use of glucagon-like peptide-1 (GLP-1) agonists in patients with type 2 diabetes in a primary care clinic. GLP-1 agonists have many benefits in patients with diabetes, including improving glycemic control, weight loss, and benefits in cardiovascular and renal outcomes in certain patient populations, such as those with clinical ASCVD. This study aims to analyze the use of GLP-1 agonists in a primary care clinic, and to assess the impact of pharmacist-managed diabetes care on these prescribing rates.

Methods: A retrospective review of electronic medical records was conducted on patients with type 2 diabetes at a rural primary care clinic. The study included patients who were at least 18 years of age, had type 2 diabetes, and were current patients of the clinic as of March 2025. Data collected from the medical records included demographic data, past medical history, pharmacist involvement, hemoglobin A1c, weight, renal function, and diabetes medication prescribing history. The primary outcome of this study was to analyze the prescribing rates of GLP-1 agonists in patients with type 2 diabetes. Descriptive analysis methods were used to assess overall prescribing rates of GLP-1 agonists in this population, as well as subgroup analyses including patients managed by pharmacists, and patients with certain comorbidities such as clinical atherosclerotic cardiovascular disease (ASCVD).

Results: A total of 499 patients met inclusion criteria and were included in the analysis. Of the 499 patients, 164 patients (32.9%) were managed by pharmacists. A total of 209 patients (41.9%) had an active prescription for an incretin-based medication. Within the pharmacist-managed patient population, a total of 86 patients had a GLP-1 agonist, representing 52.4% of pharmacist-management patients. For those without a pharmacist, a total of 123 patients had a GLP-1 agonist, representing 36.7% of patients without a pharmacist. Of the 499 patients with type 2 diabetes, 58 patients had clinical ASCVD, and 35 of these patients had active pharmacist management. Within the group of patients with type 2 diabetes and clinical ASCVD managed by a pharmacist, 21 patients (60%) were prescribed a GLP-1 agonist. When compared to patients with type 2 diabetes and clinical ASCVD without a pharmacist, 8 patients (34.8%) were prescribed a GLP-1 agonist.

Conclusions: Patients managed by a pharmacist received GLP-1 agonists at higher rates than those without a pharmacist on their care team. Patients with clinical ASCVD were more likely to receive a GLP-1 agonist for cardiovascular benefits than those patients without a pharmacist. Results of this study support that the addition of a pharmacist in a primary care clinic can have a positive impact on prescribing rates of GLP-1 agonists, particularly in patients with clinical ASCVD. Further studies will be conducted to expand pharmacy services to fill gaps of care and improve population-wide prescribing patterns.