Febrey Sam, Nunns Michael, Buckland Jill, Abbott Rebecca, Bethel Alison, Whear Rebecca, Boddy Kate, Melendez-Torres G J, Coon Jo Thompson, Shaw Liz
Isca Evidence, University of Exeter Medical School, Faculty of Health & Life Sciences, University of Exeter, St Lukes Campus, Exeter, Devon, UK.
NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, St Lukes Campus, Exeter, Devon, UK.
Health Expect. 2025 Apr;28(2):e70251. doi: 10.1111/hex.70251.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a pharmacological treatment option for both diabetes and weight loss. Qualitative evidence is vital in providing greater understanding of patients, practitioners and carers experience of taking or delivering GLP-1 RAs. This evidence can inform the current or future configuration and delivery of services. We conducted a scoping review to better understand the quantity, nature and key characteristics of qualitative primary evidence which explores the experiences, views and perceptions of patients, carers and clinicians regarding the use of GLP-1 RAs.
Four bibliographic databases were searched on 10 July 2024: MEDLINE, APA PsycInfo via Ovid, CINAHL Ultimate via EBSCOhost, ProQuest Dissertations and Theses Global via ProQuest. We also searched Google Scholar, two clinical trials registries, the pre-print server medRxiv and conducted citation searches. We sought qualitative research about the experiences of patients, carers and practitioners about any aspect of taking or prescribing GLP-1RAs, for any indication. Study selection and data extraction were performed by two independent reviewers. The included studies were collated, and their characteristics were described.
After de-duplication 1545 titles and abstracts were screened for relevance, with 77 full-text articles assessed for eligibility, resulting in 25 included studies. More studies were focused on type 2 diabetes (n = 12) than weight loss (n = 9) or any indication (n = 4). The experiences of carers were not represented. No one area of experience (e.g. different indications or viewpoints) was well represented, either due to the absence or narrow focus of studies or lack of an in-depth analytical approach.
Whilst primary qualitative evidence exploring patient and clinician experience of GLP-1 RAs was identified in this scoping review, the findings highlight a need for more robust qualitative research to be conducted across all user groups, in particular involving carers, and especially for the indication of weight loss within service settings. This evidence gap needs to be urgently addressed to ensure GLP-1 RAs are appropriately prescribed and patients and carers receive support from services suited to their needs.
Seventeen public collaborators contributed to the search by suggesting additional search terms, helping define the population for inclusion and contributing to protocol development. Their thoughts on the findings of the review helped form the basis for the discussion of this paper.
胰高血糖素样肽-1受体激动剂（GLP-1 RAs）是糖尿病和减肥的一种药物治疗选择。定性证据对于更深入了解患者、从业者和护理人员服用或提供GLP-1 RAs的体验至关重要。该证据可为当前或未来的服务配置及提供提供参考。我们进行了一项范围综述，以更好地了解定性原始证据的数量、性质和关键特征，该证据探讨了患者、护理人员和临床医生对使用GLP-1 RAs的体验、观点和看法。
于2024年7月10日检索了四个文献数据库：MEDLINE、通过Ovid检索的APA PsycInfo、通过EBSCOhost检索的CINAHL Ultimate、通过ProQuest检索的ProQuest Dissertations and Theses Global。我们还检索了谷歌学术、两个临床试验注册库、预印本服务器medRxiv并进行了引文检索。我们寻找关于患者、护理人员和从业者在服用或开具GLP-1 RAs的任何方面的体验的定性研究，针对任何适应症。研究选择和数据提取由两名独立评审员进行。对纳入的研究进行整理，并描述其特征。
在去除重复项后，筛选了1545篇标题和摘要的相关性，对77篇全文文章进行了资格评估，最终纳入25项研究。关注2型糖尿病（n = 12）的研究比关注减肥（n = 9）或任何适应症（n = 4）的研究更多。护理人员的体验未被涉及。由于研究的缺失或重点狭窄，或缺乏深入的分析方法，没有一个经验领域（如不同适应症或观点）得到充分体现。
虽然在这项范围综述中发现了探索患者和临床医生使用GLP-1 RAs体验的原始定性证据，但研究结果强调需要对所有用户群体进行更有力的定性研究，特别是涉及护理人员的研究，尤其是在服务环境中针对减肥适应症的研究。这一证据空白需要紧急解决，以确保GLP-1 RAs得到适当处方，患者和护理人员能从适合其需求的服务中获得支持。
17名公众合作者通过提出额外的检索词、帮助定义纳入人群以及参与方案制定，为检索工作做出了贡献。他们对综述结果的看法有助于形成本文讨论的基础。
