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E-raamat: Drug Research and Development for Adults Across the Older Age Span: Proceedings of a Workshop

  • Formaat: 142 pages
  • Ilmumisaeg: 29-Dec-2021
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309685719
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  • Formaat: 142 pages
  • Ilmumisaeg: 29-Dec-2021
  • Kirjastus: National Academies Press
  • Keel: eng
  • ISBN-13: 9780309685719
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There is a void in evidence-based information for making informed decisions on how to optimize care for older adults, particularly those 80 years and over. Because older adults are vastly underrepresented in clinical trials, there is a dearth of information about the appropriate use of drugs in this population. Yet older adults have higher rates of comorbidities and simultaneous use of multiple medications than the general population, and are the majority users of many medications. Additionally, age-related physiological and pathological changes, particularly for adults 80 years of age and older, can lead to significant differences in the pharmacokinetics (PK)2 and pharmacodynamics (PD)3 of a given drug compared to the general population.



On August 5 and 6, 2020, the National Academies of Sciences, Engineering, and Medicine hosted a workshop titled Drug Research and Development for Adults Across the Older Age Span. The workshop was designed to examine the challenges and opportunities in drug research and development for older adult populations, explore barriers that impede safety and efficacy studies in these populations, and share lessons learned for better understanding clinical pharmacology for populations over age 65. This publication summarizes the presentation and discussion of the workshop.

Table of Contents



Front Matter 1 Introduction 2 Inclusion of Older Adults in Clinical Trials: An Evolving Landscape 3 Overcoming Key Barriers 4 Alternative Study Approaches 5 Strategies for Engaging Older Adults in Clinical Research 6 Clinical Trials in the Era of COVID-19 and Beyond 7 Reflections and Key Takeaways Appendix A: References Appendix B: Workshop Agenda Appendix C: Speaker Biosketches
Acronyms And Abbreviations xix
1 Introduction
1(4)
2 Inclusion Of Older Adults In Clinical Trials: An Evolving Landscape
5(14)
Knowledge Gaps and Issues Unique to Older Adults
6(2)
Age-Related Changes That Impact Drug Metabolism
8(2)
Barriers to Conducting Clinical Trials That Include Older Adults
10(5)
Discussion
15(4)
3 Overcoming Key Barriers
19(16)
Inclusion/Exclusion Criteria and Trial Design
20(4)
Organ Function Criteria Expansion
24(2)
Regulatory Considerations
26(2)
Ethical Considerations
28(3)
Discussion
31(4)
4 Alternative Study Approaches
35(14)
Adaptive Trial Design
36(1)
Home-Based Clinical Trials
37(3)
Real-World Clinical Trials
40(2)
Quantitative Systems Pharmacology Models
42(2)
Clinical Trial Simulation
44(2)
Discussion
46(3)
5 Strategies For Engaging Older Adults In Clinical Research
49(16)
Outreach and Networking Strategies for Engaging Older Adults
50(4)
Los Angeles Barbershop Blood Pressure Study
54(3)
A Patient Perspective
57(1)
A Caregiver Perspective
58(1)
A Community Provider Perspective
59(2)
Discussion
61(4)
6 Clinical Trials In The Era Of Covid-19 And Beyond
65(14)
A Regulatory Perspective
66(2)
A Clinician Perspective
68(2)
Telehealth Applications
70(3)
Digitization of Medicine
73(1)
A Patient Perspective
74(1)
Discussion
75(4)
7 Reflections And Key Takeaways
79(12)
Transparency and Engagement
79(1)
Practical Application of Science and Policy
80(2)
Enabling Innovation
82(1)
Discussion
83(4)
Reflections
87(4)
Appendixes
A References
91(8)
B Workshop Agenda
99(10)
C Speaker Biosketches
109