Effectiveness of therapeutics and health care services in reducing racial disparities in Alzheimer's disease

治疗和医疗保健服务在减少阿尔茨海默病种族差异方面的有效性

基本信息

批准号：
9448137
负责人：
JULIE M ZISSIMOPOULOS
金额：
$ 83.26万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-30 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9448137
关键词：
Address Affect Age Alzheimer disease prevention Alzheimer&apos s Disease Alzheimer&apos s disease risk American Amyloid beta-Protein Behavioral Biological Factors Caring Cholesterol Chronic Disease Clinical Clinical Trials Clinical Trials Design Cohort Studies Computerized Medical Record Data Data Set Development Diagnosis Diagnostic Diagnostic Services Disease Drug Targeting Effectiveness Ethnic Origin Ethnic group Generations Genetic Goals Health Health Services Accessibility Healthcare Heterogeneity Hyperlipidemia Incidence Intervention Link Measures Medical Medicare Medicare claim Methodology Methods Minority Molecular Not Hispanic or Latino Patient Self-Report Patients Persons Pharmaceutical Preparations Pharmacologic Substance Pharmacotherapy Physicians Pilot Projects Population Population Heterogeneity Positioning Attribute Prevention Prevention approach Psychotropic Drugs Quality of Care Race Randomized Controlled Trials Research Risk Sampling Services Surveys Therapeutic Time Treatment Protocols Variant Visit Woman age group base bench to bedside beneficiary care delivery combat disease diagnosis electronic data ethnic difference ethnic diversity follow-up health care availability health care service health disparity health service use innovation insight longitudinal analysis medical specialties medication compliance men nondrug therapy novel therapeutics power analysis prevent programs racial and ethnic racial and ethnic disparities racial difference racial disparity racial diversity response sex socioeconomics symptom treatment therapeutic effectiveness therapy design treatment effect

项目摘要

Effectiveness of therapeutics and health care services in reducing racial disparities in Alzheimer's disease (PI: Zissimopoulos) Project Summary The origins of racial disparities in Alzheimer's disease are multifaceted ranging from risk of AD, to access to care, to delivery of care, to genetic variance in response to care. In the proposed program of research, we will approach the challenge of racial and ethnic disparities in Alzheimer's disease (AD) from two perspectives: use of and response to drug therapies for non‐AD conditions that influence risk of AD and; health care treatments for AD. Our goals are to identify racial and ethnic differences in both and, once identified, elucidate opportunities for potential AD prevention and treatment regimens across diverse populations. To achieve these goals, we will conduct analyses using longitudinal Medicare claims data on over 10 million persons per year. Medicare claims data have several advantages over other types of data such as clinical trial data, survey data or data from electronic medical records: 1) Medicare beneficiaries are of the age group at greatest risk for AD, persons ages 65 or older, beneficiaries are of both sexes and all races and come from diverse socioeconomic backgrounds; 2) the magnitude of the Medicare population provides sufficient number of persons by sex and by race to conduct statically powered analyses; 3) data contain details on all prescribed drug therapies and health care treatments and services reimbursed by Medicare and they are not limited by error in self‐report measures common in survey data. Aim 1 will identify drug therapies currently used to treat non‐AD conditions that may affect AD risk. Expert panelists will help prioritize the evidence and provide insight into probable variations across sex, race and ethnicity. Aim 2 will analyze the influence of these drug treatments on incidence of AD and differences in the association across sex, race and ethnicity. Aim 3 will evaluate racial disparities in AD diagnoses and treatments over time, including diagnosis methods; the specialties of diagnosing physicians; initiation and use of AD and other psychotropic drugs; timing and regularity of physician visits; and the factors associated with differences across diverse race and ethnic populations. This research will inform drug targets and the design of clinical trials, as well as AD treatment and care interventions to reduce racial disparities in combating the disease.

治疗和医疗保健服务在减少阿尔茨海默氏症疗法方面的有效性疾病（PI：Zissimopoulos）项目摘要阿尔茨海默氏病主要差异的起源是多方面的，从AD风险到进入护理，提供护理，以应对护理的遗传差异。在拟议的研究计划中我们将面对两种阿尔茨海默氏病（AD）中种族和种族差异观点：在影响AD风险的非AD条件下使用和对药物疗法的反应； AD的医疗保健治疗。我们的目标是确定两者的种族和种族差异，一次确定，阐明潜在潜水员的潜在AD预防和治疗方案的机会人群。为了实现这些目标，我们将使用纵向Medicare索赔数据进行分析每年超过1000万人。 Medicare索赔数据比其他类型的数据，例如临床试验数据，调查数据或电子病历的数据：1）Medicare 受益人是年龄段的广告最大风险，年龄在65岁或以上的人，受益人是性别和所有种族都来自潜水员的社会经济背景； 2） Medicare人口通过性行为提供足够数量的人，并通过种族进行静态进行有能力的分析； 3）数据包含有关所有处方药疗法和医疗保健治疗的详细信息以及由Medicare偿还的服务，它们不受自我报告措施的错误限制在调查数据中。 AIM 1将识别目前用于治疗非AD疾病的药物疗法影响广告风险。专家小组成员将帮助优先级证据并提供有关可能的可能性的见解性别，种族和种族的变化。 AIM 2将分析这些药物治疗对广告发生的发生率以及性别，种族和种族之间的关联差异。 AIM 3将评估随着时间的推移，包括诊断方法在内的AD诊断和治疗方面的种族差异；专业诊断医生； AD和其他精神药物的启动和使用；时间和规律性实体访问；以及与潜水员种族和族裔种群差异有关的事实。这项研究将非正式的药物靶标和临床试验的设计以及AD治疗和护理减少治疗师打击疾病的干预措施。