Developing drug products in an aging society. From concept to prescribing

Abstract

This book aims to address the major aspects of future drug product development and therapy for older adults, giving practical guidance for the rational product and clinical development and prescribing of drug products to this ever growing segment of the population. With authors coming from key “aging” markets such as Europe, the USA, China and Japan, the book will provide valuable information for students, scientists, regulators, practitioners, and other healthcare professionals from academia, industry and regulatory bodies. Foreword 1; Foreword 2; Preface; Contents; Contributors; Introduction; 1 Healthcare Provisions in an Aging Society: U.S. Perspective; Abstract; Introduction; Changing Demographics; Age Change; Racial Changes and Immigration; Marital Status; Life Stressors; Income; Living Arrangements; Food Insecurity; Neighborhood Factors; Prevalence of Diseases; Introduction; Dementia; Disability; Depression; Cardiovascular Diseases; Cancer; Other; Medicare; Affordable Care Act ("Obamacare"); Proposed Benefits; Anticipated Issues; Primary Care and Access to Health Care; Medications Future-Opportunities for the Pharmaceutical IndustryReferences; 2 Healthcare Provision in an Aging Society-The European Perspective; Abstract; Introduction; Older People in Europe; Demography of Aging in Europe; Prevalence of Diseases/Disability in Europe; Medication Use in Europe; An Introduction to Overprescribing and Underprescribing; Health Services for Older People; Discussion of Public Health Services with Individual Country Examples; Prescribing for Older People; National Guidelines and Cost-Effectiveness Arrangements; European Actions; European Medicines Agency Actions on Representation of Older People in Clinical TrialsActions on Inappropriate Prescribing and Failure to Prescribe Appropriate Medications; Prescribing Toward End of Life; Conclusion/Discussion; References; 3 Healthcare Provisions in the Aging Society: Japanese Perspectives; Abstract; Introduction; Japan's Population is the Oldest in the World and is Getting Even Older; Universal Access and Excellent Population Health for Relatively Low Healthcare Costs; Japan's Healthcare System; Long-Term Care; How Population Aging Manifests Itself in Health Care and Communities? Japan's Healthcare Reforms for 2025: Community-Based Integrated Care SystemConclusion; References; The Patient(s); 4 Old, Very Old and Frail; Abstract; Introduction; References; 5 Age and the Process of Aging; Abstract; Introduction; The Process of Aging; Age-Related Changes in Physiological Function; Age-Related Changes in Pharmacokinetics; Drug Absorption; First-Pass Metabolism and Bioavailability; Drug Distribution in the Body; Protein Binding; Drug Clearance; Liver; Kidney; Age-Related Changes in Pharmacodynamics; Anticoagulants; Cardiovascular Drugs; Calcium Channel Blockers Beta-Blocking AgentsCentral Nervous System-Active Drugs; Variability in Response to Medicines; Information Needed for Appropriate Prescribing to Older Patients; Conclusion; References; 6 Comprehensive Geriatric Assessment; Abstract; Ten Target Areas for Geriatric Screening; Functional Assessment; Fall Assessment; Cognitive Assessment; Screening, Evaluation, and Differential Diagnosis; References; 7 Patients' Clinical Characteristics, Disease Experience, and Perception; Abstract; Introduction; Multimorbidity; Impact of Age on Health and Daily Functioning