Primary Care Providers May Be Key to Faster Alzheimer’s Treatment

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Primary Care Providers May Be Key to Faster Alzheimer’s Treatment


Widespread availability of effective disease-modifying therapies (DMTs) might be a breakthrough in slowing the progression of early-stage Alzheimer’s disease (AD) to later stages of dementia. An AD DMT has received traditional approval from the Food and Drug Administration, and more candidates are on the horizon. The authors used a simulation model to assess patient demand and provider supply for the delivery of AD DMTs. They expanded on prior modeling by including the capacity of primary care practitioners (PCPs) who perform brief cognitive assessments and by utilizing county-level data.

The results suggest that engaging the primary care workforce in the diagnostic process might be vital to accelerate the delivery of AD DMTs, which will overwhelm neurology and geriatric practices that often already have wait lists for appointments. Under the base case assumptions, the states with the longest wait times are Alaska, Arkansas, Idaho, Mississippi, Montana, Nevada, Oklahoma, and Wyoming. Primary care models and telehealth models can help improve access to care in these areas. Further work is needed to evaluate how primary care–led models of care can widely and effectively evaluate and manage treatment for people with early-stage AD, as well as how technological advancements, such as improved biomarkers and computerized testing, can be integrated into workflows.

This research was sponsored by Genentech and conducted within the Access and Delivery Program of RAND Health Care.

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