Assessing Awareness, Confidence and Utilization of Compounded GLP-1 and Dual GIP/GLP-1 Receptor Agonists Among Healthcare Clinicians and Pharmacists: A Comprehensive Survey Study

Abstract

Introduction/Objectives

Misinformation about the safety, efficacy and legality of compounded Glucagon-like peptide-1 receptor agonists and dual action Glucose-dependent Insulinotropic Polypeptide/Glucagon-like peptide-1 receptor agonists (GLP-1 and dual GIP/GLP-1 RA) exists amongst the public. Literature describing healthcare professionals’ current awareness and use of these products is limited. The objective of this study is to examine healthcare clinicians’ and pharmacists’ knowledge and patient care practices for compounded GLP-1 and dual GIP/GLP-1 RAs.

Methods

An observational, cross-sectional 14-item survey was distributed to clinicians and pharmacists who care for patients prescribed GLP-1 or dual GIP/GLP-1 RA in regular practice located throughout a multi-site health system in December of 2025. Responses were collected through REDCap and analyzed using Wilcoxon Rank-Sum and Chi-Square tests.

Results

Of 523 surveys distributed, ninety-nine eligible responses were analyzed. Fifty-one percent of respondents were aware of the 2024 American Diabetes Association (ADA) guidance statement on compounded GLP-1 and dual GIP/GLP-1 RAs. A majority of respondents expressed low confidence in the safety of these agents and have not incorporated them into practice citing safety, efficacy, legality and knowledge gaps. Many respondents expressed a desire for additional education.

Conclusion

Use of compounded GLP-1 and dual GIP/GLP-1 receptor agonists continues despite regulatory changes and is likely to persist. Gaps in knowledge, awareness, and confidence regarding safety, efficacy, and regulation may be limiting appropriate use, even as clinicians and pharmacists recognize potential benefits for cost and access. These findings expose the need for targeted, interdisciplinary education and clear guidance on compounding regulations.

Introduction

Glucagon-like peptide-1 receptor agonists and dual action Glucose-dependent Insulinotropic Polypeptide/Glucagon-like peptide-1 receptor agonists (GLP-1 and dual GIP/GLP-1 RA) are two classes of medications indicated by the U.S. Food and Drug Administration (FDA) for type 2 diabetes, weight management, risk reduction of major cardiovascular events, metabolic dysfunction-associated steatohepatitis and obstructive sleep apnea.^1-4 High consumer demand, supply shortages and prohibitive costs have contributed to an explosion in the availability and use of compounded alternatives. Safety concerns have been raised by the FDA and in late 2024, the American Diabetes Association (ADA) issued a statement recommending against the use of compounded GLP-1 and dual GIP/GLP-1 RAs.^5-7 Despite this, compounded GLP-1 and dual GIP/GLP-1 RAs remain widely used and switching from commercial to compounded versions is trending upwards within primary care practice. ⁵

Misinformation regarding the safety and efficacy of compounded GLP-1 and dual GIP/GLP-1 RAs exist, which has raised concerns among healthcare clinicians about the marketing of these medications. ⁶ One study published in 2024 identified 79 unique websites selling compounded GLP-1 and dual GLP-1 RAs and the authors concluded that consumers were often partially informed or misinformed about FDA approval and product safety or whether a product was compounded. ⁸ Several other studies have demonstrated knowledge gaps among pharmacists about GLP-1 RA use and concerns for misuse; yet, few studies have specifically investigated compounded GLP-1 RA knowledge or dual GIP/GLP-1 RA.^9-11 In February 2025, the FDA ended the shortage status for the most commonly compounded GLP-1 RA, semaglutide, creating new legal challenges to compounding practice. ¹² With the rapid changes affecting the availability and utilization of compounded medications, literature describing clinicians’ and pharmacists’ current understanding and use of compounded GLP-1 and dual GIP/GLP-1 RAs is critical to inform future practice.

Herein, we survey knowledge about safety, efficacy and legal status of compounded GLP-1 and dual GIP/GLP-1 RAs, the confidence of clinicians and pharmacists in providing patient education regarding their use, and clinician and pharmacist management of these products in current practice. By identifying gaps in knowledge and practice, the study seeks to inform targeted educational interventions and policy recommendations to improve patient outcomes and safety.

Methods

Study Design and Setting

This was an observational, cross-sectional survey study. Excluding demographic and screening questions, the survey included fourteen select-all-that-apply and Likert-scale questions across four domains: awareness, confidence, practice and learning opportunities (Appendix A). The survey was distributed to clinicians and pharmacists within the multi-site health system, including locations in Minnesota, Florida, Arizona and Wisconsin. The clinic, with a hub in Rochester, Minnesota, delivers specialty care to local, regional, national, and international patients as well as comprehensive longitudinal primary care to more than 150,000 local area residents, employees and their dependents. The health system is an affiliated regional network of 46 community clinics and hospitals delivering primary and specialty care in southern Minnesota and western Wisconsin.

The survey was distributed by departmental email lists on December 5, 2025 and remained open until January 4, 2026. The recruitment email included informed consent language and stated that survey completion indicated participant consent. Study data was collected and managed using Research Electronic Data Capture (REDCap).^13,14 Customized reminders to complete the survey were sent out three times using Dillman’s Tailored Design Method techniques to improve response rate. ¹⁵ Survey and data were stored in REDCap, a secure MySQL database, that is continuously locked, contains a full audit trail, and is endorsed by the Clinical and Translational Science Institute. Only the investigators involved in the collection and analysis of the data had access to participant response information. All survey responses were anonymous.

The study was reviewed and determined exempt by IRB. Participation in the survey was optional. Approval to distribute the survey was obtained by department chairs and was reviewed and approved by the ethics People and Culture Committee in conjunction with Human Resources prior to distribution. This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. ¹⁶

Participants

Clinicians were defined as a physician, nurse practitioner or physician assistant in an endocrinology, family medicine or internal medicine department. Pharmacists were included if they practiced in an outpatient dispensing pharmacy or clinic-based ambulatory care setting. Learners, including residents, fellows and students, were excluded from the survey. Participants were further excluded from the survey if they had current or past pharmacy compounding experience or had no experience caring for patients taking GLP-1 or dual GIP/GLP-1 RAs.

Outcomes

Survey questions were developed by the research team after consultation with a compounding pharmacist supervisor and categorized into four domains to address the objectives of this study: awareness, confidence, practice and learning (Appendix A). Within the awareness domain, participants were queried about the ADA statement regarding compounded GLP-1 and dual GIP/GLP-1 RAs and answered 2 select-all-that-apply questions about the truthfulness of statements regarding FDA and Board of Pharmacy regulation of compounding practices, the legality of compounding practices and insurance coverage of compounded GLP-1 and dual GIP/GLP-1 RAs. At the time of the survey distribution, correct statements were verified by the ADA Guidance Statement, FDA, and USP sources; however, we note federal and state regulations may change over time and other factors may affect regulations including: shortage status and patient-specific need.^7,17 Within the confidence domain, participants indicated their level of confidence using a Likert scale (very unconfident, unconfident, neutral, confident, very confident) to a variety of statements regarding safety, efficacy, affordability and use in clinical practice of compounded GLP-1 and dual GIP/GLP-1 RAs. For the practice domain, participants were asked how they had incorporated compounded GLP-1 and dual GIP/GLP-1 RAs into their practice. Survey questions within the learning domain queried participants regarding knowledge gaps and interest in learning more with respect to these compounded products. Several survey questions were used to exclude participants with prior compounding pharmacy experience to limit response bias as well as to exclude participants with no relevant GLP-1 or dual GIP/GLP-1 RA exposure. Study questions were reviewed by the research team and pilot tested by three pharmacist residents for clarity and usability.

Analysis

A sample size calculation indicated that 97 survey responses were needed for the study analysis to have a confidence level of 95% with a 10% margin of error. Assuming typical survey response rates of 20-30%, we determined that 323-485 surveys should be distributed. A standard p-value of <0.05 was used to signify statistical significance. As all study comparisons were pre-planned and in general, this study was exploratory, no study-wise adjustment to p-value was performed.

Data was analyzed using IBM SPSS Statistics (Version 29). Participant responses were reported as frequencies and percentages. Respondents were grouped by healthcare profession type. Questions on Likert response scales were treated as ordinal data, and non-parametric Wilcoxon Rank Sum Tests were used to compare the distribution of responses between groups. For categorical data, Pearson Chi-Square tests were used to assess proportional differences between groups. Fisher’s exact test was used to confirm Pearson Chi-Square findings when cell sizes were low (e.g., less than 5). Phi values from Chi-Square tests were used as an indicator of effect size, with >0.3 indicating medium effect size, and >0.5 indicating large effect size.

Results

Participant Characteristics

The survey was distributed to 523 recipients, and 125 responses were submitted (23.9% response rate). A total of 26/125 (20.8%) responses were excluded due to the following factors: Completed by learner (2/26, 7.7%), did not prescribe, dispense or care for patients taking GLP-1 or dual GIP/GLP1 RAs (6/26, 23%), were not a nurse practitioner, pharmacist, physician or physician assistant (6/26, 23%), was a pharmacist with compounding experience (4/26, 15.4%), or did not complete a single question from the main body of the survey (8/26, 30.8%). Respondents were included if they answered at least one question from the main body of the survey, indicated they prescribed, managed patients who take or dispensed GLP-1 or dual GIP/GLP-1 RAs, and indicated they were a nurse practitioner, pharmacist, physician or physician assistant. This limited the sample to 99 participants. As not all respondents answered all of the questions, the denominator was adjusted for individual questions based on the number of participants that responded.

The characteristics of participants are shown in Table 1. Of the included participants, 53/99 (53.5%) were clinicians and 46/99 (46.5%) were pharmacists. The majority of participants, 74/99 (74.7%) prescribed GLP-1 or dual GIP/GLP-1 RAs, while 14/99 (14.1%) dispensed and 11/99 (11.1%) managed patients taking GLP-1 or dual GIP/GLP-1 RAs. Among clinicians, family medicine was the most common medical practice reported, 43/53 (81.1%) while ambulatory care (i.e., primary care, anticoagulation, cardiology, pulmonology, pharmacogenomics) was the most frequently reported practice area among pharmacists, 30/43 (65.2%). Participants reported a broad range of ages, years in practice and geographical locations among Minnesota and Wisconsin. A small number of participants, 3/99 (3%) practiced in Arizona or Florida. Most of the participants were white, 82/99 (82.8%) and female, 70/99 (70.7%).

Table 1.

Characteristics of Survey Participants

Characteristic		Number (n=99)	Percentage (%)
Profession	Nurse practitioner	17	17.2
	Pharmacist	46	46.5
	Physician	29	29.3
	Physician assistant	7	7.1
Clinicians primary practice area	Family medicine	43	81.1
	Internal medicine	5	9.4
	Endocrinology	3	5.7
	Other	2	3.8
Pharmacist primary practice area	Ambulatory care	30	65.2
	Outpatient pharmacy	11	23.9
	Inpatient pharmacy	5	10.9
Geographic region of practice	Arizona	2	2
	Florida	1	1
	Rochester	11	11.1
	Northwest Wisconsin Health System	36	36.4
	Southeast Minnesota Health System	28	28.3
	Southwest Minnesota Health System	5	5.1
	Southwest Wisconsin Health System	15	15.2
	Prefer not to say	1	1
GLP-1 or dual GIP/GLP-1 RA experience	Prescribe GLP-1 or dual GIP/GLP-1 RAs	74	74.7
	Take care of patients who take GLP-1 or dual GIP/GLP-1 RAs	11	11.1
	Dispense GLP-1 or dual GIP/GLP-1 RAs	14	14.1
Years in practice	5 or fewer years	19	19.2
	6-10 years	21	21.2
	11-15 years	22	22.2
	16-20 years	11	11.1
	21-25 years	10	10.1
	More than 25 years	12	12.1
	Prefer not to disclose	4	4
Age	Less than 30 years	3	3
	30-39 years	37	37.4
	40-49 years	37	37.4
	50-59 years	18	18.2
	60 years or older	3	3
	Prefer not to disclose	1	1
Gender	Female	70	70.7
	Male	27	27.3
	Prefer not to disclose	2	2
Race/ethnicity	Asian	4	4
	Black	2	2
	Hispanic/Latinx	3	3
	White	82	82.8
	Other	1	1
	Prefer not to disclose	7	7.1

Survey Responses

Awareness

Approximately half (n=50/98; 51%) of participants who answered the question were aware of the 2024 ADA guidance statement on the use of compounded GLP-1 and dual GIP/GLP-1 RAs, with no differences found between pharmacists and clinicians.

The question regarding FDA approval, legality and insurance coverage of compounded agents was answered correctly by 42/99 (42.4%) participants. Participants were considered to have answered correctly if they selected the two true statements and did not select the false statement. The false statement was: ‘Compounded GLP-1 and dual GIP/GLP-1 RAs are covered by most insurance plans’ (correctly not selected by n=94/99, 94.9%). The two true statements were: ‘Compounded GLP-1 and dual GIP/GLP-1 RAs are not FDA approved,’ (correctly selected by n=70/99, 70.7%) and ‘It is legal for pharmacies to compound GLP-1 and dual GIP/GLP-1 RAs when there is a national shortage’ (correctly selected by n=66/99, 66.7%)

The question regarding regulation of compounded pharmacies was answered correctly by 20/99 (20.2%) participants. Participants were considered to have answered correctly if all three of the following statements were selected as being true: ‘Compounding pharmacies are regulated by state boards of pharmacy’ (correctly selected by n=53/99, 53.3%), ‘Compounding pharmacies are regulated by the FDA’ (correctly selected by n=24/99, 24.2%), and ‘Despite regulations, safety concerns have been raised by FDA regarding some compounding pharmacies’ (correctly selected by n=92/99, 92.9%).

Comparing responses between pharmacist and clinician groups, a higher proportion of pharmacists correctly answered the first question regarding the regulation and insurance coverage of compounded agents (n=27/46, 58.7%, vs. n=15/53, 28.3%, Phi 0.307, Pearson Chi-Square p-value 0.002). For the second question regarding compounding pharmacies, a higher proportion of pharmacists correctly answered the question (n=16/46, 34.8% vs. n=4/53, 7.5%, Phi 0.338, Pearson Chi-Square p-value <0.001, Fisher’s Exact Test p-value <0.001). Phi values for each of these tests indicate a medium effect size.

Confidence

More than 50% of participants reported feeling confident or very confident that compounded products are more affordable than commercial products (n=65/94; 69.1%) and meet some patient needs not otherwise met by commercial products (n=54/94; 57.4%). Alternatively, more than 50% indicated being unconfident or very unconfident that compounded products are as safe as commercial products (n=71/95; 74.7%), contain the ingredients listed on the label in the declared potency and do not contain harmful levels of contaminants (n=62/92; 67.4%) and are as effective as commercial products (n=54/95; 56.8%). Participants were also unconfident or very unconfident in how to prescribe compounded products (n=73/89; 82%) and in sending a prescription for a compounded product to a licensed compounding pharmacy (n=68/88; 77.3%). These results are summarized in Figure 1.

Figure 1.

Confidence levels for compounded GLP-1 and dual GIP/GLP-1 RAs

When comparing clinicians to pharmacists, pharmacists had lower levels of confidence regarding the safety of compounded compared to commercial products (n=43, Mean Rank 41.62 vs. n=52, Mean Rank 53.28; p=0.029), and higher levels of confidence providing education on administration technique of compounded products (n=43, Mean Rank 57.92 vs. n=49, Mean Rank 36.48; p<0.001), and monitoring patients on compounded products (n=42, Mean Rank 52.5 vs. n=49, Mean Rank 40.43; p=0.026).

Practice

More than half of participants (n=52/91; 57.1%) reported not incorporating compounded products into their practice. The most common reasons for not incorporating compounded products into practice were concerns about safety (n=33/52; 63.5%), concerns about efficacy (n=30/52; 57.7%), concerns about legality (n=27/52; 51.9%) and lack of confidence or knowledge in how to prescribe (n=24/52; 46.2%). Clinicians were proportionately more likely to endorse a lack of confidence or knowledge in how to prescribe as a reason for not incorporating compounded products when compared to pharmacists (n=18/27, 66.7% vs. n=6/25 (24%), Phi -0.428, Pearson Chi-Square p-value=0.002). Less than half of participants (n=39/91; 42.9%) reported incorporating compounded products into their practice. Participants most frequently reported incorporating compounded products in their practice through counseling patients on safety and efficacy (n=27/39; 69.2%) and transitioning patients from compounded to commercial products (n=18/39; 46.2%). When comparing pharmacists and clinicians, proportionately fewer pharmacists reported referring patients to commercial online providers (n=1/17,5.9% vs. n=10/22, 45.5%), Phi -.436 Pearson Chi-Square p-value=0.006, Fisher’s Exact Test p-value=0.011).The most common reasons participants incorporated compounded products into practice were due to patient request (n=28/39; 71.8%) lower cost for patients (n=23/39; 59%), and availability during shortage (n=19/39, 48.7%). Clinicians were proportionately more likely to endorse lower cost as a reason for incorporating compounded products when compared to pharmacists (n=16/22 (72.7%) vs. n=7/17 (41.2%), Phi -0.318, Pearson Chi-Square p-value=0.047).

Learning

The topics most endorsed for future learning were safety and efficacy of compounded products (n=60/86, 69.8%), regulations on compounding pharmacies and products (n=57/86, 66.3%), microdosing compounded products (n=52/86, 60.5%), cost of compounded products (n=43/86, 50%) and how to prescribe compounded products (n=41/86, 47.7%). Among these results one significant difference was found; pharmacists were proportionately more likely to indicate microdosing as an educational activity of interest compared to clinicians (n=30/39 76.9% vs. n=22/47 (46.8%, Phi 0.307, Pearson Chi-Square p-value=0.004). Microdosing was not defined in the survey; however, it is generally understood as an off-label practice of using less than the standard dose of the GLP-1 or dual GIP/GLP-1 RA. There were 10/86 (11.6%) participants who indicated they were not interested in learning more.

Discussion

This work identified significant knowledge gaps regarding compounded GLP-1 and dual GIP/GLP-1 RAs amongst healthcare clinicians and pharmacists. This is concerning given the well-documented risks outlined in the 2024 ADA guidance statement regarding use. Notably, a majority of participants lacked awareness of ADA guidance, highlighting an important opportunity for educational interventions. Pharmacists and clinicians were similarly confident there was a need for compounded GLP-1 and dual GIP/GLP-1 RAs, however lacked confidence in how to meet that patient need safely and legally. In contrast to another survey that examined health care professional’s perceptions of the safety and efficacy of GLP-1 RAs, most participants in this study did not hold favorable views toward the safety and efficacy of compounded GLP-1 or dual GIP/GLP-1 RAs. ¹⁸ With demand for compounded products expected to continue, this identifies an important knowledge gap.

Our results indicated pharmacists demonstrated a greater awareness of factors influencing patient access to compounded GLP-1 and dual GIP/GLP-1 RAs. In addition, pharmacists were more confident than clinicians in their ability to educate patients regarding administration and monitoring of these products. These findings, in conjunction with pharmacists’ specialized training, underscore the specific role pharmacists could play when implementing compounded GLP-1 and dual GIP/GLP-1 RAs into clinical practice. Future research could focus on expanding the role of pharmacists in improving the safe and effective use of compounded GLP-1 and dual GIP/GLP-1 RAs.

The survey emphasizes the importance of enhancing education on compounded GLP-1 and dual GIP/GLP-1 RAs. This lack of awareness and confidence regarding the use of these medications is consistent among both clinicians and pharmacists. Moving forward, targeted educational efforts on microdosing of GLP-1 and dual GIP/GLP-1 RAs along with clear guidance on the safety, efficacy and regulation of compounded products and compounding pharmacies will be essential for supporting informed, patient-centered discussions.

This study has several limitations. Although the study did reach predetermined sample size to meet power, missing data for some specific comparisons reduced power to detect null findings. We aimed to include multiple geographical sites within the health system to enhance generalizability, but response rates were low outside of the Midwest region and all responses were from a single healthcare institution, which restrains external validity. The survey design did not include previously validated scales, cognitive or reliability assessments and was vetted only by the research team. Although there was a relative balance in the responses between pharmacists and clinicians, most clinicians were from Family Medicine, which may limit the generalizability of these results to other disciplines. Non-response bias and social desirability bias may also have influenced the results. ¹⁹ Finally, this observational survey was not designed to asses patient outcomes or the impact of any specific educational intervention.

Conclusion

The use of compounded GLP-1 and dual GIP/GLP-1 RAs persists despite regulatory changes and is expected to continue. A lack of knowledge, awareness and confidence amongst clinicians and pharmacists may be limiting the safe and effective use of compounded GLP-1 and dual GIP/GLP-1 RAs in practice. Despite recognizing potential patient benefits in cost and access, there remains uncertainty surrounding safety, efficacy and regulation of compounded products and compounding pharmacies which may be contributing to the limited prescribing and implementation of these products. These findings expose the need for targeted, interdisciplinary education and clear guidance on compounding regulations. Future studies are needed to evaluate the impact of such efforts in equipping clinicians and pharmacists with the knowledge and confidence necessary for appropriate prescribing, counseling and management of compounded GLP-1 and dual GIP/GLP-1 RAs and impact on patient care and clinical outcomes.

Appendix.

Appendix A.

Survey Questions and Response Options

Survey question	Response options
Awareness
I am aware of the 2024 American Diabetes Association guidance statement on the use of compounded GLP-1 and dual GIP/GLP-1 RAs.	Multiple choice (select one) • Yes • No
Which of the following statements about compounded GLP-1 and dual GIP/GLP-1 RAs are true?	Multiple choice (select all that apply) • Compounded GLP-1 and dual GIP/GLP-1 RAs are not FDA approved * • It is legal for pharmacies to compound GLP-1 and dual GIP/GLP-1 RAs when there is a national shortage * • Compounded GLP-1 and dual GIP/GLP-1 RAs are covered by most insurance plans * • None of the above
Which of the following statements about compounding pharmacies are true?	Multiple choice (select all that apply) • Compounding pharmacies are regulated by state boards of pharmacy • Compounding pharmacies are regulated by the FDA • Despite regulations, safety concerns have been raised by the FDA regarding some compounding pharmacies • None of the above
Confidence
How confident are you in the accuracy of the following statements about compounded GLP-1 and dual GIP/GLP-1 RAs: • Compounded GLP-1 and dual GIP/GLP-1 RAs are as safe as commercial products • Compounded GLP-1 and dual GIP/GLP-1 RAs are as effective as commercial products • Compounded GLP-1 and dual GIP/GLP-1 RAs meet some patient needs not otherwise met by commercial products • Compounded GLP-1 and dual GIP/GLP-1 RAs are more affordable than commercial products	Likert scale 1-5 for each statement 1 = very unconfident 2 = unconfident 3 = neutral 4 = confident 5 = very confident
How confident are you that a compounded GLP-1 or dual GIP/GLP-1 RA product contains the ingredients listed on the label in the declared potency and amount and does not contain harmful levels of contaminants?	Likert scale 1-5 for each statement 1 = very unconfident 2 = unconfident 3 = neutral 4 = confident 5 = very confident
How confident are you with the following: • Providing patients with education regarding the safety and efficacy of compounded GLP-1 and dual GIP/GLP-1 RAs • Providing patients with education on administration technique of their compounded GLP-1 or dual GIP/GLP-1 RA product • Prescribing compounded GLP-1 and dual GIP/GLP-1 RAs • Sending a prescription for a compounded GLP-1 or dual GIP/GLP-1 RAs to a licensed compounding pharmacy • Monitoring patients on compounded GLP-1 and dual GIP/GLP-1 RAs • Transitioning a patient from a compounded GLP-1 and dual GIP/GLP-1 RAs to a commercially available product	Likert scale 1-5 for each statement 1 = very unconfident 2 = unconfident 3 = neutral 4 = confident 5 = very confident
Practice
How have you incorporated compounded GLP-1 and dual GIP/GLP-1 RAs in your practice?	Multiple choice (select all that apply) • Prescribe compounded agents • Manage patients prescribed compounded GLP-1 and dual GIP/GLP-1 RAs by another provider • Counsel patients on safety and efficacy of compounded GLP-1 and dual GIP/GLP-1 RAs • Transition patients from compounded GLP-1 and dual GIP/GLP-1 RAs to commercial products • Refer patients to commercial online provider (i.e., HERS) to obtain compounded GLP-1 or dual GIP/GLP-1 RAs • Other (fill in blank) • I have not incorporated compounded agents in practice yet, but I plan to in the future
For what reason(s) have you incorporated compounded GLP-1 and dual GIP/GLP-1 RAs in your practice?	Multiple choice (select all that apply) • Availability during shortage • Lower cost for patients • Patient request • Ability to individualize dosing • Other (fill in blank)
For what reason(s) have you NOT incorporated compounded GLP-1 and dual GIP/GLP-1 RAs in your practice?	Multiple choice (select all that apply) • Concerns about safety • Concerns about legality • Concerns about efficacy • Concerns about cost • Lack of confidence or knowledge in how to prescribe • No concerns • Other (fill in blank)
Learning
What topics regarding compounded GLP-1 and dual GIP/GLP-1 RAs would you like to learn more about?	Multiple choice (select all that apply) • Safety and efficacy of compounded GLP-1 or dual GIP/GLP-1 RAs • Regulations on compounding pharmacies and products • How to prescribe compounded GLP-1 or dual GIP/GLP-1 RAs • Microdosing compounded GLP-1 or dual GIP/GLP-1 RAs • Cost of compounded GLP-1 or dual GIP/GLP-1 RAs • Other (fill in blank) • None

Footnote.

*These statements were considered true, participants were considered to have answered correctly if they selected these responses. At the time of the survey distribution, correct statements were verified by the ADA Guidance Statement, FDA, and USP sources; however, we note federal and state regulations may change over time and other factors may affect regulations including: shortage status and patient-specific need.^7,14

ORCID iD

Audrey Umbreit https://orcid.org/0000-0003-4930-4497

Ethical Considerations

This study was submitted to IRB and found exempt.

Consent to Participate

Participation in the survey was optional. Results are anonymous.

Consent for Publication

All authors agreed with publication of this article.

Data Availability Statement

With IRB approval, institutional DUAs, and offset of costs, reasonable requests for study data will be granted and can be made to the corresponding author.*