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Advancing Care

Published in Providence Heart Beat magazine, Spring, 2012

Research at Providence plays a vital role in developing treatments for the future

Story by Amy Lynn Smith • Photos by Comrade Studios & Gary Matoso

Katherine Tuttle, MD, directs Spokane medical research with a special focus on providing for the poor and vulnerable.
Katherine Tuttle, MD, directs research with a special focus on providing for the poor and vulnerable.

Without medical research, there would be no antibiotics to treat infection, no insulin to manage diabetes, and no way to successfully transplant a kidney. These are just three of the countless examples of medical treatments made possible through research—and the list of new discoveries expands nearly every day.

Providence Medical Research Center is among the leading centers performing this work. Clinical research is conducted as part of the Mission of Providence Sacred Heart Medical Center & Children’s Hospital and Providence Holy Family Hospital.

“I think most people aren’t aware that Sacred Heart really is the academic medical center in Eastern Washington, by virtue of the scholarly activities occurring here,” says Katherine Tuttle, MD, executive director for research. “That includes our robust research program, as well as our training programs that encompass medical students, residents and fellows.”

Providence Medical Research Center is the only physician-led, comprehensive medical research center in the Inland Northwest. The program performs what is known as “bench-to-bedside-to-community” research, which emphasizes studies that translate into practical applications of advances in medical care. Providence participates in multicenter trials and also originates its own studies, looking at every area of medicine ranging from the search for new medications to best practices in delivery of care.

A Meaningful Mission

According to Dr. Tuttle, there are currently more than 300 studies under way. These cover most specialties in both adult and pediatric medicine—such as cardiology, neurology, gastroenterology and endocrinology, as well as primary care. The center also operates an active basic science research program largely focused on diabetes and kidney disease.

The Providence Mission is fundamental to the work of the Medical Research Center. “Our program serves the Mission by advancing knowledge essential to improving care of the poor and the vulnerable,” says Dr. Tuttle.

Many scientific discoveries made at Providence have evolved into clinical trials. This includes one that received a National Institutes of Health (NIH) grant in 2011—one of only five such grants to study ways to improve the science of delivering optimal care to people with kidney disease.

Providence received the grant based on its own initial study, which proved the difference education can make in outcomes after hospitalization. Although there are very good treatments for people with kidney disease, without instruction on managing multiple medications, these patients are at high risk for readmission to the hospital and possible death.

Researchers at Providence conducted a pilot study that found that when medication discrepancies are eliminated, readmission rates and costs dropped by 50 percent among all hospital patients. For kidney patients, the risk of readmission was reduced by 90 percent.

The NIH grant will fund a two year trial at Providence to study the impact of improved medication management education. A pharmacist will visit patients at home within five days of discharge from the hospital, to help them understand their medications and how to take them properly.

“Our grant was funded because of our work on the original study, which showed the dramatic reduction in readmissions and our data demonstrating that kidney disease patients are at highest risk,” says Dr. Tuttle. “We have to figure out the best ways to deliver treatment to people, or even the most novel therapies will not have the necessary impact.”

A Spectrum of Studies

The “novel therapies” Dr. Tuttle mentions are new treatments—another important area of research at Providence. Studies are currently under way in kidney transplantation, for instance, exploring alternative approaches to managing immune suppression while reducing the toxicity of medication.

Other examples include a study evaluating a medication to prevent stroke and heart attack in people with a history of certain types of strokes, and another to compare different kinds of biopsies used in people with lung disease. (See below for details on other Providence trials.)

Research conducted at Providence falls under the jurisdiction of the U.S. Food and Drug Administration, which approves the use of any drugs or medical devices involving human subjects at Providence Medical Research Center. Working closely with physician investigators, the center constantly evaluates the impact of research-based treatment approaches to ensure the highest level of patient safety.

The work of Providence has a healthy future ahead, thanks to a focus on fiscal responsibility and appropriate funding. As Dr. Tuttle points out, the center doesn’t exist to make a profit, but to discover new and better ways to provide health care.

“We have an absolute commitment to excellence at all levels, from the science itself to the importance of the clinical issue to how we perform and deliver research studies,” she says. “We try to choose studies that really matter in terms of staying true to the Providence Mission and advancing patient care.”

Spotlight on Current Research Studies

A closer look at trials under way at the Providence Medical Research Center reveals the wide range of conditions and therapies studied there on a regular basis.

Condition: Fecal incontinence, or the involuntary loss of stool.

  • Goal: Explore alternative treatment options, which are currently limited.

  • Lead Investigator: Shane McNevin, MD, leading physician at the Providence Continence Center and program director for the gastrointestinal section of Providence Cancer Center.

  • Specifics: One study investigates the safety and effectiveness of a new implantable device made up of magnetic beads attached with wires and implanted around the muscles that control continence.

    A second study evaluates a mesh device that provides support of the pelvic floor in women. The device, similar to one used to control urinary incontinence, is implanted using a minimally invasive procedure.

Condition: Atypical hemolytic-uremic syndrome (aHUS ), an autoimmune disorder.

  • Goal: Evaluate the safety and effectiveness of a medication to treat children and adolescents with aHUS . The medication prevents the breakdown of red blood cells that can lead to anemia, kidney failure and other health issues related to aHUS.

  • Lead Investigator: Joel Hernandez, MD, pediatric nephrologist at Providence Sacred Heart Medical Center & Children’s Hospital.

  • Specifics: So far, about 13 children have been enrolled in the study, which is being conducted at approximately 20 centers worldwide. One of the first study participants was diagnosed with aHUS at 9 months of age. He was given infusions of the medication, which put his aHUS into remission—and at nearly 2 years of age, he’s a healthy and active toddler.