Background: Digital health platforms with provider-based care (PBC) have a unique position to facilitate pharmacotherapy and lifestyle modification interventions; however, more is to be learned about who and how patients want to interact with these offerings.1-4 This study used a mixed methods approach to analyze digital health member data, as well as desired experience in a digital PBC weight management (PBC-WM) program to inform future product development.

Methods: A retrospective analysis assessed digital diabetes (DM) and weight (WM) management member demographics and engagement to provide insights between members using no medications (No Med), weight loss medications excluding semaglutide or tirezepatide (Med1), and semaglutide or tirezepatide (Med2) who had an observable weight at 12 months (5/1/2023-12/1/2023) (N=4,606). One-way ANOVA was used to analyze weigh-ins and chi-square test for coaching engagement. These findings influenced a deeper investigation through moderated 1:1 interviews to assess participants’ interest in a GLP-1 PBC-WM program, education needs, and understanding gaps for improvement of early prototypes. Interview participants were eligible with a history of type 2 diabetes and hypertension, body mass index (BMI) ≥35 mg/kg2, previous weight loss attempts, and scored >6 on willingness to explore WM drugs survey (survey scale: 0=not at all to 10=yes, absolutely).

Results: Members included 52.3% No Med, 10.1% Med1, and 37.5% Med2. Med2 was 62.7% men with a higher baseline BMI (37.5 SD 8.90) compared to Med 1 (36.7 SD 8.73) and No Meds (34.4 SD 8.11). Med2 recorded more weights than members in No Med and Med1 (p<0.001) and engaged in coaching more than No Med (p=0.016). Interview participants (N=8) were 50% female, 37.5% Black, 25% Hispanic, 75% with BMI >40 kg/m2, and 62.5% had previous GLP-1 use. Participants viewed GLP-1s as a WM tool and expressed the need for a care team that included provider, coach, and technology to support questions, medication, and lifestyle change.

Discussion: This study showed that members of a digital DM and WM program who used GLP-1s have prolonged participation in self-monitoring and coaching. Both self-monitoring technology and support are desired tools for individuals interested in PBC-WM with GLP-1 access. Therefore, program design should include a variety tech-based engagement tools and multi-channel care team communication to foster behavior change and greater outcomes.