An $8.4 million American Recovery and Reinvestment Act (ARRA) award from the Agency for Healthcare Research and Quality will enhance the infrastructure of the Indiana Network for Patient Care (INPC), a health information exchange (HIE). The grant supports research that uses data from INPC in comparative effectiveness benefits and harms of three drugs used to treat Alzheimer's disease.
Both the infrastructure expansion, already underway, and the research study, Comparative Effectiveness Research Trial of Alzheimer's Disease Drugs (COMET-AD), will serve as a nationwide model.
The INPC enhancement will provide insights into regional HIEs and the potential for a national network. Results of the COMET-AD study will provide guidance to clinicians, patients and caretakers nationwide.
The grant is one of 10 Prospective Outcome Systems Using Patient-specific Electronic Data to Compare Tests and Therapies (PROSPECT) awards and advances the strength of the Regenstrief Institute in medical informatics, aging [population] research and the clinical pharmacology expertise of the Indiana University School of Medicine.
Patients participating in the COMET-AD study will be randomized for treatment with donepezil (Aricept), rivastigmine (Exelon) or galantamine (Reminyl)--all Food and Drug Administration- approved treatments for Alzheimer's disease. No patients will receive a placebo. The nearly 300 study participants will be patients at five memory care practices located within four central Indiana health care systems.
Regenstrief Institute investigator Malaz Boustani, MD, MPH, associate professor of medicine at the IU School of Medicine and IU Center for Aging Research center scientist, is the principal investigator on the COMET-AD study.
"COMET-AD focuses on a very vulnerable population – older adults with cognitive problems. Designing and building a health information technology infrastructure to help answer questions for this group with its many co-occurring diseases for which they take a variety of drugs, who have functional symptoms, and who often present with other issues, means we will be able to answer questions that will be relevant for all populations," Boustani wrote. "And the results of our study will help physicians determine which drug is better for which patient. With the vast amount of information that INPC will provide, we may determine that one drug is best for all patients or we may find that certain patients do better with one drug than another."