domains/health/glp-1-persistence-drops-to-15-percent-at-two-years-for-non-diabetic-obesity-patients-undermining-chronic-use-economics.md

@@ -103,17 +103,23 @@ Weight regain data shows GLP-1 alone (8.7 kg regain) performs no better than pla
 
 
 ### Additional Evidence (extend)
-*Source: [[2026-01-13-aon-glp1-employer-cost-savings-cancer-reduction]] | Added: 2026-03-19*
+*Source: 2026-01-13-aon-glp1-employer-cost-savings-cancer-reduction | Added: 2026-03-19*
 
 Aon data shows benefits scale dramatically with adherence: for diabetes patients, medical cost growth is 6 percentage points lower at 30 months overall, but 9 points lower with 80%+ adherence. For weight loss patients, cost growth is 3 points lower at 18 months overall, but 7 points lower with consistent use. Adherent users (80%+) show 47% fewer MACE hospitalizations for women and 26% for men. This confirms that adherence is the binding variable—the 80%+ adherent cohort shows the strongest effects across all outcomes, making low persistence rates even more economically damaging.
 
 ---
 
 ### Additional Evidence (extend)
-*Source: [[2026-03-21-natco-semaglutide-india-day1-launch-1290]] | Added: 2026-03-21*
+*Source: 2026-03-21-natco-semaglutide-india-day1-launch-1290 | Added: 2026-03-21*
 
 Novo Nordisk's response to India's generic launch reveals market expansion strategy: only 200,000 of 250 million obese Indians are currently on GLP-1s. The company is competing on 'market expansion over price war,' suggesting the primary barrier is access/awareness, not price sensitivity. This implies persistence challenges may be access-driven in international markets rather than purely adherence-driven.
 
+### Additional Evidence (extend)
+*Source: [[2025-04-01-jmir-glp1-digital-engagement-outcomes-retrospective]] | Added: 2026-03-24*
+
+US real-world data from JMIR 2025 shows digital engagement produces 11.53% weight loss vs. 8% for non-engaged participants at month 5 (3.5pp advantage). Study covers both semaglutide and tirzepatide, demonstrating the behavioral support effect generalizes across GLP-1/GIP receptor agonists. When supply and coverage issues are addressed, persistence improves to 63%, suggesting the adherence gap is partially addressable through digital platform integration (live coaching, monitoring, education).
+
+
 
 Relevant Notes:
 - [[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]

inbox/queue/2025-04-01-jmir-glp1-digital-engagement-outcomes-retrospective.md

@@ -7,9 +7,13 @@ date: 2025-04-01
 domain: health
 secondary_domains: []
 format: research-paper
-status: unprocessed
+status: enrichment
 priority: medium
 tags: [glp1, semaglutide, digital-health, behavioral-support, adherence, weight-loss, atoms-to-bits, belief-4, real-world-data]
+processed_by: vida
+processed_date: 2026-03-24
+enrichments_applied: ["glp-1-persistence-drops-to-15-percent-at-two-years-for-non-diabetic-obesity-patients-undermining-chronic-use-economics.md"]
+extraction_model: "anthropic/claude-sonnet-4.5"
 ---
 
 ## Content
@@ -59,3 +63,12 @@ PMC archive: PMC11997532.
 PRIMARY CONNECTION: Belief 4 atoms-to-bits + Session 4/5 GLP-1 adherence thread
 WHY ARCHIVED: US real-world confirmation of Danish study finding; adds data point for oral semaglutide FDA approval as a potential adherence game-changer
 EXTRACTION HINT: Update existing GLP-1 adherence claim with US real-world data; create new claim for oral semaglutide adherence pathway if not already in KB
+
+
+## Key Facts
+- JMIR 2025 study (PMC11997532) shows engaged GLP-1 users achieve 11.53% mean weight loss vs. 8% for non-engaged at month 5
+- Study covers both semaglutide and tirzepatide, demonstrating cross-molecule effect
+- GLP-1 persistence improves from ~50% to 63% when supply and coverage issues are addressed
+- Danish study previously showed online weight-loss program + semaglutide at half typical dose → 16.7% weight loss over 64 weeks
+- Oral semaglutide received FDA approval for weight management in 2026
+- Digital platform components: live group video coaching, text-based in-app support, dynamic educational content, real-time weight monitoring, medication adherence tracking