Use and Impact of Novel and Repurposed Therapeutics for Alzheimer's Disease and Related Dementia in Diverse Populations

项目摘要 AD/ADRD新疗法的加速发展和重新调整用途的努力 治疗其他慢性病的常用处方药预示着未来有机会 降低AD/ADRD风险和负担。然而，对AD/ADRD的需求和使用 在服务不足的非西班牙裔黑人社区中，治疗是不确定的，他们处于高位 由于结构性等因素，AD/ADRD的风险和使用障碍尤为严重 种族主义和医疗系统的不信任。非西班牙裔黑人社区的成员仍然处于- 包括在AD/ADRD研究中，现有的有限证据表明，非 西班牙裔黑人老年人被诊断为AD/ADRD晚于非西班牙裔白人 美国人不太可能接受后续护理、专家护理和可用的治疗方法 在AD/ADRD诊断后。促进公平地采用未来AD/ADRD的一项战略 治疗是确定和量化潜在痴呆症的需求和获得障碍 来自非西班牙裔黑人利益相关者的治疗和新疗法的实际使用 适用于非AD/ADRD条件。在规划阶段，我们将与非西班牙裔黑人接触 利益相关者，并采用NIA的健康差异框架来指导使用限定性和 确定和引出衡量与准入和管理相关的关键因素的量化方法 对新的和重新调整用途的疗法的需求。在实施阶段，我们将收集和 分析来自研究参与者和具有全国代表性的数据源的数据。我们将量化 在非西班牙裔黑人中开始、坚持和停用药物的可能性 治疗费用、疗效、给药和副作用情况各不相同。我们将聘用 这些措施使用经过验证的动态微观模拟模型来量化下游 新的和重新调整用途的疗法对医疗费用以及认知和身体的影响 非西班牙裔黑人男女的健康和生活质量。调查结果将通知目标 确保公平获得减少疾病风险和负担的治疗的机会 在非西班牙裔黑人社区，并将量化 治疗公司将为改善健康结果的公共支出和药物创新努力提供信息 和实现公平。

Project Summary The accelerating development of novel AD/ADRD therapeutics and efforts to repurpose commonly prescribed drugs for other chronic conditions foreshadows future opportunities to reduce AD/ADRD risk and burden. However, the demand for and access to AD/ADRD therapeutics is uncertain in underserved non-Hispanic Black communities who are at elevated AD/ADRD risk and face barriers to use that are particularly acute due to factors such as structural racism and medical system distrust. Members of non-Hispanic Black communities remain under- included in AD/ADRD research and the limited evidence available demonstrates that non- Hispanic Black older adults are diagnosed with AD/ADRD later than non-Hispanic White Americans and are less likely to receive follow-up care, specialist care and available therapeutics after an AD/ADRD diagnosis. One strategy to facilitate equitable uptake of future AD/ADRD therapies is to identify and quantify the demand for and access barriers to potential dementia treatments from non-Hispanic Black stakeholders’ perspectives and actual use of novel therapies for non-AD/ADRD conditions. In the planning stage, we will engage non-Hispanic Black stakeholders and employ NIA’s Health Disparities Framework to guide use of qualitive and quantitative methods to identify and elicit measurement of key factors related to access and demand for novel and repurposed therapeutics. In the implementation stage, we will collect and analyze data from study participants and nationally representative data sources. We will quantify likelihood of drug initiation, adherence, and discontinuation among non-Hispanic Blacks across therapeutics with varying cost, efficacy, administration, and side-effect profiles. We will employ the measures using a validated dynamic microsimulation model to quantify the downstream impact of novel and repurposed therapeutics on health care costs and the cognitive and physical health and quality of life of non-Hispanic Black men and women. Findings will inform targeted opportunities for ensuring equitable access to therapeutics that reduce disease risk and burden in non-Hispanic Black communities and will quantify the health and economic impacts of therapeutics to inform public spending and drug innovation efforts for improving health outcomes and achieving equity.