Professional Knowledge, Clinical Practices, and Regulatory Alignment Regarding GLP-1 and Dual GIP/GLP-1 Therapies Among Pharmacists and Physicians in Tripoli, Libya

Abstract

GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists have changed the management of type 2 diabetes and obesity, while rapidly expanding demand has intensified the need for professional knowledge, appropriate prescribing, prescription-controlled dispensing, and regulatory oversight. This study was conducted to assess pharmacists' and physicians' knowledge and professional practices regarding semaglutide and tirzepatide in Tripoli, Libya, and to interpret these findings in relation to current international regulatory frameworks. A cross-sectional descriptive-analytic study was conducted from January to May 2026 among 72 pharmacists and 25 physicians recruited from community pharmacies, hospitals, and clinics. Structured questionnaires assessed professional background, self-reported knowledge, dispensing or prescribing practice, clinical assessment, safety perceptions, and patient-use patterns. Moderate knowledge predominated among pharmacists (73.6%), whereas 52.0% of physicians reported high knowledge. Most pharmacists perceived increasing use (86.1%), yet 36.1% reported dispensing without a physician prescription. Among physicians, 88.0% requested HbA1c before treatment, 84.0% requested renal and liver function tests and fasting blood glucose, and 76.0% assessed BMI. Physicians frequently encountered appetite loss (84.0%) and nausea (80.0%), while 88.0% considered patient information insufficient before use. Professional practice in Tripoli shows a marked contrast between generally cautious physician assessment and a substantial prescription-control gap at the pharmacy level. The findings support stronger professional education, consistent prescription-only dispensing, structured counseling, pharmacovigilance, and alignment with WHO, FDA, EMA, ANSM, and MHRA principles for medically supervised GLP-1 and dual GIP/GLP-1 therapy.