Perceptions of Glucagon-like Peptide 1 Receptor Agonists Among Individuals With Knee Osteoarthritis and Excess Weight: A Qualitative Study

Objective: Glucagon-like peptide 1 receptor agonists (GLP-1RAs) facilitate weight loss and reduce pain among individuals with knee osteoarthritis (OA). We investigated attitudes and barriers influencing GLP-1RA use among individuals with knee OA and excess weight to draw distinctions in perspectives between patients with and without GLP-1RA experience. Methods: In this cross-sectional qualitative study guided by the Framework Analysis method, we conducted structured interviews with persons with knee OA and excess weight. The moderator's guide included questions about health, weight loss history, and thoughts and experiences related to GLP-1RAs. Of the 286 patients prescreened, 30 completed an interview, after which saturation was reached. Interview transcripts were coded by research assistants using Dedoose software, and themes were identified using inductive analysis, charting, and memo writing. Results: The 30 individuals interviewed were majority female and most self-identified as White. Fifteen participants had current or prior GL-P1RA use, and fifteen had never taken GLP-1RAs. We identified four major themes: (1) health care providers were the primary GLP-1RA information source; (2) most participants recognized that weight loss could contribute to knee pain relief; (3) “ever users” reported overall positive experiences and found GLPA-1RAs helped facilitate healthy lifestyle changes, whereas “never users” more often described medications as a last resort after lifestyle changes fail; and (4) cost was the most significant barrier to GLP-1RA use. Conclusion: We found that perceptions both differed and overlapped among participants with and without prior GLP-1RA use. Clinicians should address potential concerns regarding GLP-1RAs when discussing treatment options with patients with excess weight and knee OA.