Enhanced Medication Management to Control ADRD Risk Factors Among African Americans and Latinos

项目摘要/摘要 阿尔茨海默病和相关痴呆(ADRD)对少数族裔的影响不成比例-非裔美国人是2倍 更有可能的是，拉美裔/拉丁裔患ADRD的可能性是美国白人的1.5倍。最近，阿尔茨海默氏症 影响运动(AIM)和阿尔茨海默氏症协会支持以下建议 因素--特别是高血压和糖尿病--降低非裔美国人和 拉美裔/拉美裔美国人。药物可以非常有效地控制高血压和糖尿病，但不幸的是 对这些药物的依从性普遍较低，特别是在非裔美国人和拉美裔/拉美裔美国人中。边缘 对降压药的依从性(60%-80%)是不够的，因为这些患者仍然有显著的 开发ADRD的风险增加(与完全遵守者相比增加3倍，与高度遵守者相比增加2.5倍)。 因此，优化服药依从性的有效主动解决方案可以对患者产生积极影响 人口。 拟议的解决方案将是为提供商设计的药物管理服务。完整的解决方案是 包括：(A)市面上可购买的电子药丸分发机，可发送服用/遗漏药丸的短信通知；(B) 基于历史数据的未来遵从性评估，以及(C)提供与遵从性相关的提供商门户 信息。为了解决非洲裔美国人和拉美裔美国人在ADRD方面的差异，初步实施将 特别侧重于为这些社区的老年人提供护理的提供者。

Project Summary/Abstract Alzheimer’s disease and related dementias (ADRD) disproportionately affects minorities – African Americans are 2x more likely and Hispanics/Latinos are 1.5x more likely than white Americans to have ADRD. Recently, the Alzheimer’s Impact Movement (AIM) and the Alzheimer’s Association supported the recommendation of “better management of risk factors – particularly high blood pressure and diabetes – to reduce the risk of ADRD among African Americans and Hispanics/Latinos.” Medications can be very effective in managing both hypertension and diabetes, but unfortunately adherence to these medications is commonly low, particularly among African Americans and Hispanics/Latinos. Marginal adherence (60%-80%) with anti-hypertensive medication is inadequate because these patients still had significantly elevated risks (3x greater compared to fully adherent, 2.5x greater compared to highly adherent) of developing ADRD. Hence, an effective pro-active solution for optimizing medication adherence can positively impact this patient population. The proposed solution will be a medication management service designed for providers. The full solution would comprise of: (A) a commercially available electronic pill dispenser that sends SMS notifications of pills taken/missed, (B) future adherence assessment based on historical data, and (C) a provider portal which presents adherence-related information. To address the disparity in ADRD among African Americans and Latinos, the initial implementation will specifically focus on providers who deliver care to older adults in these communities.