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

新型和改造疗法在不同人群中治疗阿尔茨海默病和相关痴呆症的使用和影响

• 批准号: 10655203
• 负责人: DAVID ALAN BENNETT
• 金额: $ 32.1万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655203
• 关键词: Acceleration; Acute; Adherence; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Alzheimer' s disease therapeutic; American; Black Populations; Black race; California; Caring; Chronic; Cognitive; Communities; Community Outreach; Complex; Data; Data Analyses; Data Collection; Data Sources; Dementia; Development; Diagnosis; Disparity; Drug Prescriptions; Economics; Elderly; Ensure; Environmental Risk Factor; Equity; Face; Focus Groups; Future; Goals; Health; Health Care Costs; Healthcare Systems; Hispanic Populations; Improve Access; Intervention; Measurement; Measures; Medical; Medicare claim; Methods; Modeling; Not Hispanic or Latino; Online Systems; Outcome; Participant; Patient Recruitments; Persons; Pharmaceutical Preparations; Population; Population Heterogeneity; Public Health; Publications; Quality of life; Research; Resource Sharing; Risk Reduction; Safety; Sampling; Specialist; Structural Racism; Surveys; System; Therapeutic; Uncertainty; United States; Universities; access restrictions; barrier to care; black men; black women; burden of illness; caucasian American; cohort; cost; dementia risk; design; disorder risk; distrust; drug repurposing; economic impact; economic outcome; ethnic minority; evidence base; experience; follow-up; health disparity; health equity; high risk; improved; innovation; member; minority communities; models and simulation; multidisciplinary; novel; novel therapeutics; physical conditioning; preference; prevent; programs; racial minority; recruit; side effect; simulation; social culture; stakeholder perspectives; tool; uptake; user-friendly

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.

项目概要 新型 AD/ADRD 疗法的加速发展以及重新利用的努力 治疗其他慢性病的常用药物预示着未来的机会 降低 AD/ADRD 风险和负担。然而，对 AD/ADRD 的需求和获取 在服务水平较低的非西班牙裔黑人社区中，治疗方法不确定 AD/ADRD 风险和面临的使用障碍尤其严重，原因包括结构性因素 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以下状态： 包括在 AD/ADRD 研究中，并且现有的有限证据表明，非 西班牙裔黑人老年人被诊断出 AD/ADRD 的时间晚于非西班牙裔白人 美国人接受后续护理、专科护理和可用疗法的可能性较小 AD/ADRD 诊断后。一项促进未来 AD/ADRD 公平采用的战略 治疗的目的是确定和量化潜在痴呆症的需求和获取障碍 非西班牙裔黑人利益相关者的治疗方法和新疗法的实际使用 对于非 AD/ADRD 条件。在规划阶段，我们将聘请非西班牙裔黑人 利益相关者并采用 NIA 的健康差异框架来指导使用定性和 识别和测量与获取和获取相关的关键因素的定量方法 对新颖和改变用途的治疗方法的需求。在实施阶段，我们将收集并 分析来自研究参与者和全国代表性数据源的数据。我们将量化 非西班牙裔黑人开始用药、坚持用药和停药的可能性 具有不同成本、功效、给药方式和副作用的治疗方法。我们将聘用 使用经过验证的动态微观模拟模型来量化下游的措施 新颖和重新调整用途的疗法对医疗保健成本以及认知和身体的影响 非西班牙裔黑人男性和女性的健康和生活质量。调查结果将告知目标 确保公平获得降低疾病风险和负担的治疗方法的机会 在非西班牙裔黑人社区中，并将量化其对健康和经济的影响 为改善健康结果的公共支出和药物创新工作提供信息的治疗方法 并实现公平。