Published: June 27, 2011
Updated: June 27, 2011
Since 1996, Duke Primary Care practices have participated in more than 70 clinical studies involving more than 6,000 patients -- generating evidence that improves primary care nationwide.
When the American Heart Association released new guidelines for preventing cardiovascular disease in women earlier this year, it relied, in part, on research conducted at Duke Primary Care practices.
Those studies, which investigated ways to control high blood pressure and promote physical activity and lifestyle changes, are part of a vibrant culture of clinical research within Duke’s primary care clinics.
Although patients may think of their primary care office as a place to get checkups and flu shots rather than a hotbed of cutting-edge research, primary care is actually a critical hub in the process of translating advances in medicine into “real world” practice, says Rowena Dolor, MD, director of Duke’s Primary Care Research Consortium.
“To really find out how a drug works, or if a preventive care intervention is effective, you have to test it in a busy clinical practice where the care is delivered on a daily basis,” she explains.
It is more difficult for that to take place within the walls of an academic medical center like Duke because of the highly selective population it’s designed to serve. “Less than 5 percent of community care is delivered at the hospital,” Dolor says. “Ninety percent is done in the outpatient setting by community physicians.”
DPC clinics, such as Duke Primary Care Butner-Creedmoor, which has been participating in research since the network’s inception, see patients ages one to 101. “That helps researchers collect a wide range of useful data,” says Tamra Stall, MD.
There are benefits for patients, too. Those who choose to participate in the research gain access to new vaccines, medications, diagnostic procedures, and behavioral interventions. They are among the first to pioneer new ways to conquer obesity, lower blood pressure, manage their weight, or quit smoking.
“We look for ways to help patients to make behavioral changes and sustain that change,” says Hayden Bosworth, PhD, a Duke researcher who is a principal investigator of many studies conducted in DPC clinics.
“For example, when we studied African-Americans with diabetes and heart disease, we wanted to make sure patients understood what medicines they were taking, and we wanted to know if they were following their doctors’ orders, or what prevented them from doing so. Armed with that knowledge, we can come up with ways to effect change.”
Doctors at Duke Primary Care Pickett Road are conducting a study looking at whether knowing one’s genetic risk for diabetes will motivate patients to change their lifestyle behaviors.
“The patients want to participate,” says Scott Joy, MD, Pickett Road’s medical director. “Their interest is very high.”
The information gathered in these and other studies often leads to advances in patient care, as well as new evidence-based treatment guidelines, like those recently announced by the American Heart Association.
“The research we conduct in DPC results in publications that expert panels review for these type of guidelines,” Dolor says.
Find out about Duke clinical trials currently seeking volunteers.