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

项目摘要 新型AD/ADRD治疗药物的加速开发和重新定位的努力 其他慢性疾病的常用处方药预示着未来的机会， 降低AD/ADRD风险和负担。然而，对AD/ADRD的需求和获得 在服务不足的非西班牙裔黑人社区， AD/ADRD风险和面临的使用障碍，由于结构性因素， 种族主义和对医疗系统的不信任。非西班牙裔黑人社区的成员仍然在- 包括在AD/ADRD研究中，现有的有限证据表明， 西班牙裔黑人老年人被诊断为AD/ADRD的时间晚于非西班牙裔白色人 美国人和不太可能接受后续护理，专科护理和可用的治疗 在AD/ADRD诊断之后。一项促进公平吸收未来反倾销/反倾销和反歧视战略的战略 治疗的目的是识别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观点和新疗法的实际使用 对于非AD/ADRD条件。在计划阶段，我们将与非西班牙裔黑人 利益相关者，并采用NIA的健康差异框架，以指导使用定性和 确定和衡量与获取和使用有关的关键因素的定量方法 对新的和再利用的治疗方法的需求。在实施阶段，我们会收集及 分析来自研究参与者和国家代表性数据来源的数据。我们将量化 非西班牙裔黑人中药物开始、依从性和停药的可能性 具有不同成本、功效、给药和副作用特征的治疗剂。我们会委聘 使用经过验证的动态微观模拟模型来量化下游的措施 新的和再利用的治疗方法对医疗保健成本和认知和身体的影响 非西班牙裔黑人男女的健康和生活质量。调查结果将告知目标 确保公平获得减少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，并将量化的健康和经济影响， 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 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.