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.

项目摘要 新颖的广告/ADRD疗法的加速发展以及改革的努力 针对其他慢性疾病的普遍处方药，预示着未来的机会 降低AD/ADRD风险和Burnen。但是，对广告/ADRD的需求和访问 在高度升高的非西班牙裔黑人社区中，治疗尚不确定 AD/ADRD风险和使用壁垒的使用尤其是由于结构性的因素 种族主义和医疗体系不信任。非西班牙裔黑人社区的成员仍然不足 AD/ADRD研究中包括，可用的有限证据表明，非 西班牙裔黑人老年人被诊断出与非西班牙裔白色晚期诊断为AD/ADRD 美国人，不太可能接受后续护理，专业护理和可用治疗 在进行广告/ADRD诊断之后。一种促进未来广告/ADRD公平吸收的策略 疗法是识别和量化对潜在痴呆症的需求和获取障碍 从非西班牙裔黑人利益相关者的观点和新型疗法的实际使用 对于非AD/ADRD条件。在计划阶段，我们将参与非西班牙裔黑人 利益相关者和员工NIA的健康差异框架，以指导使用合理的使用和 定量方法识别和引发与访问和访问有关的关键因素的测量 对新颖和再利用疗法的需求。在实施阶段，我们将收集并 分析研究参与者和国家代表性数据源的数据。我们将量化 非西班牙裔黑人之间的毒品启动，依从性和中断的可能性 具有不同成本，效率，给药和副作用概况的治疗药。我们将雇用 使用经过验证的动态微仿真模型来量化下游的度量 新颖和重新利用的疗法对医疗保健成本以及认知和身体的影响 非西班牙裔黑人男女的健康和生活质量。调查结果将告知目标 确保公平获得治疗的机会，以降低疾病风险并燃烧 在非西班牙裔黑人社区中，将量化 治疗剂，以告知公共支出和毒品创新，以改善健康成果 并实现公平。