NIH clinical trial initiative: Agency reaches out to primary care

Main Category: Public Health
Also Included In: Primary Care / General Practice
Article Date: 31 May 2004 - 2:00 PDT

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The research needs of primary care physicians can be met through networks where questions spring from shared experience.

Washington -- Community-based physicians do not often look to the vast National Institutes of Health for answers to questions that haunt them daily, whether they involve the care of diabetic patients or the expeditious handling of lab results.

But NIH is considering reaching out to these doctors and their patients as resources for some of its many clinical trials.

"There is a segment of the physician and patient community that is rarely involved in clinical research activities," noted Duane Alexander, MD, director of the National Institute of Child Health and Human Development. As a first step, a feasibility study will be conducted that will include assessing physician interest in becoming a part of a new network, he said.

Many primary care physicians, however, as well as those in other specialties, have not been waiting for an invitation from NIH but have been enrolling their patients in clinical trials for years. They belong to one of the more than 100 such networks that explore questions that strike close to home.

These networks, which could serve as a model for the NIH initiative, have examined such varied issues as the management of laboratory test results in family practices and the effect of a patient's insurance status on treatment decisions. Several networks are now determining the best ways to motivate patients to adopt healthier lifestyles.

The NIH proposal to tap community physicians as well as dentists and nurse practitioners and their patients as a resource was put forward as part of a "roadmap" for future NIH research by NIH Director Elias Zerhouni, MD.

"At the end of the day, all of our efforts will come to naught if we do not translate [research findings] into clinical practice," said Dr. Zerhouni, speaking to physicians at the AMA's annual national advocacy conference this spring.

There has been a major shift in medicine from the treatment of acute conditions to chronic conditions and disease prevention, thus moving the focus from academic medical centers to communities, he said. Dr. Zerhouni envisions a future of standardized data reporting from large clinical research networks that include academic centers and community physicians.

If the NIH proposal were enacted, participation in clinical trials could add interest to participating physicians' practices by providing patients an opportunity that might not otherwise be available, Dr. Alexander said.

By Susan J. Landers, AMNews staff.

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