Publications by authors named "R Handels"
The advancement of disease-modifying treatments (DMTs) for Alzheimer's disease (AD), along with the approval of three amyloid-targeting therapies in the US and several other countries, represents a significant development in the treatment landscape, offering new hope for addressing this once untreatable chronic progressive disease. However, significant challenges persist that could impede the successful integration of this class of drugs into clinical practice. These challenges include determining patient eligibility, appropriate use of diagnostic tools and genetic testing in patient care pathways, effective detection and monitoring of side effects, and improving the healthcare system's readiness by engaging both primary care and dementia specialists.
View Article and Find Full Text PDFIntroduction: Informal care estimates for use in health-economic models are lacking. We aimed to estimate the association between informal care time and dementia symptoms across Europe.
Methods: A secondary analysis was performed on 13,529 observations in 5,369 persons from 9 European pooled cohort or trial studies in community-dwelling persons with dementia.
Article Synopsis
- Dementia, particularly with severe behavioral and psychological symptoms (BPSD), greatly affects quality of life and is a main cause of death in older adults; this study looked at factors predicting mortality in these patients.
- Over 4 years, 32.5% of 508 participants with severe BPSD died, with non-survivors generally being older, more likely male, and showing greater symptom severity and lower cognitive and functional capabilities at the start.
- Key mortality predictors identified were male sex, older age at diagnosis, higher BPSD severity scores, lower cognitive function, worse daily living capabilities, and lower quality of life, while the use of antidepressants was linked to a reduced mortality risk.
Objectives: Decision-analytic models assessing the value of emerging Alzheimer's disease (AD) treatments are challenged by limited evidence on short-term trial outcomes and uncertainty in extrapolating long-term patient-relevant outcomes. To improve understanding and foster transparency and credibility in modeling methods, we cross-compared AD decision models in a hypothetical context of disease-modifying treatment for mild cognitive impairment (MCI) due to AD.
Methods: A benchmark scenario (US setting) was used with target population MCI due to AD and a set of synthetically generated hypothetical trial efficacy estimates.
Article Synopsis
- - The study introduces the IPECAD open-source model framework, designed for economic evaluations of early Alzheimer's disease treatments, enhancing transparency and credibility in reimbursement decisions.
- - The model was validated against existing models and tested for various uncertainties, revealing that its findings on life-years and cost savings were significantly lower than those of other models like ICER and AD-ACE.
- - IPECAD exemplifies the potential of open-source research in health decision-making by allowing researchers to cross-validate and analyze uncertainties in treatment assessments, fostering an open science approach in Alzheimer's research.