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

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.