PracticalDermatology

With skin conditions impacting an estimated 1.9 billion individuals around the globe, including one in four Americans, the services of the dermatological community have never been more in demand.¹ Combined with a steady increase in skin conditions like skin cancer and atopic dermatitis causing more individuals to seek out dermatological help than ever before, it’s easy to understand why many dermatologists feel that their plates are too full to consider adding clinical research to their menu of offerings.

Yet, as our understanding of dermatological and other diseases becomes more specific and personalized, clinical research and health care are moving inevitably toward each other. We know that any two individuals suffering from a similar condition may have widely varying reactions to the same course of treatment. As we explore the impact of our individual genetics on how diseases affect us, we’ll need research more than ever to discover why some treatments are working and why others aren’t.

Financially speaking, skin conditions have an annual impact on the US health care system in the neighborhood of $75 billion.² These dollars go toward not just medical procedures, but preventive care and medication costs. However, clinical research holds the promise of novel treatments and therapies that could potentially mitigate costs for patients, providing more effective care and allowing them to lead happier, more fulfilling lives.

As new models for clinical research continue to evolve, integrating clinical research into an existing private practice has become far more appealing, with clear benefits not just for patients, but for the practice itself.

What It Means for Physicians

A prevailing stereotype about clinical research is that incorporating it into a private practice would require physicians to add another time-consuming responsibility to their already busy schedule. But one new model of clinical research is specifically designed with those concerns in mind, and is intended to augment dermatologists’ existing practices while integrating naturally within their well-established workflows.

This model places a fully functioning clinical research unit inside a practice’s existing footprint or in a nearby location, along with clear signage that provides a sense of familiarity for patients, so they view the research arm as being an extension of their provider’s care. The clinical research partner shares in the expenses of business operations, including upfitting and building out a research facility; hiring, training and managing the staff; insuring quality and regulatory compliance; and pharmaceutical relations to gain access to research studies.

The upside for physicians is being able to provide cutting-edge treatments for patients in their communities who would otherwise not have access to them, while diversifying their practices and creating an avenue for patients seeking new treatment options.

Bringing clinical research into an existing dermatological practice also has the benefit of distinguishing that practice from others in the local or regional community. Patients like to feel that their dermatologist is at the forefront of new drug discovery and technologies that might be the solution for hard-to-treat conditions. Providers can nurture confidence in patients while building a new service line and creating a sophisticated, fully integrated research center of excellence in their practice.

Why This Model Works

Dermatologists’ longstanding relationships with their patients is one of the key factors that makes this model of clinical research so effective. Across all clinical research studies, the patient retention rate has traditionally been 70%.³ One reason for this low rate is patients losing interest in participation, particularly if they’re not experiencing any perceived improvement in their condition. In addition, they often have to travel to a new or unfamiliar location to participate in a trial. In the new model, these limitations are overcome by bringing clinical research to their familiar point of medical care. Patients view research as an extension of their physician’s care, making it far more likely they will complete the trial.

Using this method, rates of study completion have been proven to exceed 90%. And every successfully completed study not only benefits the patients who participate, but also brings new knowledge to the existing body of research, driving further innovations.

How Tech Supports the Model

The biggest challenge in clinical research has always been finding patients whose conditions fit into the specific parameters of a particular trial. However, emerging AI and machine-learning technology are helping to streamline and improve this once time-consuming process. These tools can examine data in the EHR, such as doctors’ notes, labs and imaging results, and create curated patient rankings for specific trials.

Using real-time EHR integration and AI-driven risk stratification and prioritization, clinical research staff can quickly identify patients who are promising candidates for a particular study and know which patients to call first. From there, research staff can flag those patients on the provider’s schedule and discuss the potential of study participation with them. Provider investigators oversee the activities of the trial, amounting to approximately 1.5 hours per week of additional responsibilities, and most physicians find this to be a rewarding and manageable trade-off.

Research Drives Innovation

All of healthcare is becoming a research engine, with 450,000 clinical trials currently enrolling patients. This number has increased exponentially due to precision medicine, as advanced biomarker diagnostics narrow the scope of each trial. At the same time, the number of active investigators has been decreasing as traditional researchers retire, leaving huge growth potential in investigator development.

Dermatology remains a robust specialty for innovation and new drug discovery through clinical research. Arguably, all stakeholders benefit the most from research based in community practices, where patients love and trust their physicians while providing a level of diversity that is underrepresented in current research trials.

With clinical research becoming more critical than ever for continued medical progress, all of these factors combine to make innovative integrated research models a highly promising avenue for the future of dermatology.

1.Peck GM, Roberson FA, Feldman SR. Why Do Patients in the United States Seek Care from Dermatologists? Dermatology and Therapy. 2022;12(4):1065-1072. doi:https://doi.org/10.1007/s13555-022-00706-0

2. American Academy of Dermatology Association. Skin conditions by the numbers. Aad.org. Published 2019. https://www.aad.org/media/stats-numbers

3. Patient Retention: Quality of Life Is Key. Citeline. Published November 6, 2023. Accessed November 14, 2023. https://www.citeline.com/en/resources/clinical/clinical-trial-retention-quality-of-life