Paving the Way for Improved Patient Assessment, Diagnosis and Care for Alzheimer’s Disease

Approximately 6.2 million Americans age 65 and older are living with dementia due to Alzheimer’s disease (AD) in 2021, and by 2050, that number is projected to double to 12.7 million.

According to the Alzheimer's Association, AD may be underdiagnosed, which means the prevalence may be higher. AD is often diagnosed at late stages and is treated with medications that only moderately impact symptoms, but do not slow disease progression.

The U.S. Food and Drug Administration (FDA) ruled in favor of a new AD treatment yesterday, which experts call a potential “game changer” in AD treatment and care.

With new AD therapies on the horizon, Premier has developed tools for health systems to use to assess, diagnose and care for patients who may be appropriate candidates for new AD treatments.

Premier Applied Sciences® (PAS), the research and analytics division of Premier, conducted research and held discussions with health professionals spanning neurology, geriatrics, neuropsychology, psychiatry, radiology, infusion, memory disorders program coordination and formulary management.

The goal was to learn about how these pros typically prepare for new therapies, which team members are involved across the health system and what types of tools and checklists would help them implement the new therapies in a way that meets their patients’ needs most effectively.

This work highlighted a lack of standardization in the care of patients with AD. It also revealed that providers may underuse current, evidence-based guidelines on AD diagnosis, such as assessment of cognitive concerns in primary care visits.

Now, experts have new therapies targeting the underlying pathology of AD in the brain, such as amyloid beta plaques, in clinical development. New therapies will require rethinking the care pathway for AD and integrating lab orders, AD biomarker confirmation (e.g., via PET scans or lumbar punctures), repeated infusions, radiology appointments and care coordination – making it critically important for health systems to understand how to manage and coordinate this potentially complex patient journey.

Should a new therapy prove successful, health systems will need to change the way they provide care for patients with dementia due to AD.

PAS’s collaboration with health professionals yielded findings on the current patient journey and workflow, and we built a System Care Pathway for Alzheimer’s Disease that health systems can use as a model to optimize care for these patients.

Premier’s System Care Pathway for Alzheimer’s Disease

The pathway is an important starting point on our interactive Site Readiness Framework for Alzheimer’s Disease that uses Premier’s 3Is™ (Identification, Intervention, Interaction) methodology to organize a health system’s approach to improving AD care and to help health systems understand their ability to adopt potential new approaches to the care of patients with AD.

The framework provides an overview of the AD patient journey as well as strategies and tools to support detection and management. The primary expected users of these tools are system leaders, service line leaders and operational leaders.

Multi-disciplinary Benefits

Providing better patient care for the AD patient population requires teamwork from roles including lab/pathology, pharmacy, supply chain, care coordination and infusion.

For operations purposes, the pathway serves at the system level to match tools, resources and structures to each department as needed, and it relies on neurology for confirmation and refinement of processes.

For neurology functions, the pathway serves at the clinical level to match tools, resources and structures to each department as needed, and it promotes collaboration with Operations for confirmation and refinement of processes.

The benefits of a multi-disciplinary approach include:

• Earlier identification of patients with mild cognitive impairment.
• Coordinated patient access to multiple clinicians working together as a care team.
• Robust tracking of results and outcomes for continuous quality improvement.

The Road Ahead

The burden of AD on the U.S. healthcare system is substantial and costly. In 2021, the total national cost of caring for people with AD and other types of dementia is projected to reach $355 billion. Improved patient assessment, diagnosis and care of these patients is critical to bringing these costs down and slowing the progression of the disease.

Premier, the PAS team and our partners are committed to this work and will continue to advance our research and develop technology-enabled tools to help health systems better prepare and improve their processes for treating this vulnerable patient population.

Learn More

• Health system leaders can access the System Care Pathway for Alzheimer’s disease at no cost. Contact us for more information.
• If you’re interested in being involved with future research studies, contact us for more information.