From bench-top to bedside
How research begun 20 years ago is transforming patient care today
Lawson Health Research Institute’s Dr. David Bailey is no stranger to publicity. Two years before he competed for Canada at the 1968 Olympics, he was the first Canadian to run a sub four-minute mile. He later went on to meet Roger Bannister, the first in the world to break the four-minute barrier.
“I thanked him for being an important motivational influence in my life,” says Dr. Bailey. “Much of what I have learned from athletics, like time management, hard work, determination and discipline, I’ve applied to my career in research.”
Dr. Bailey’s early experience as a celebrity in sport served him well when he became the focal point of international media attention last year after he and his colleagues published their latest research study. The study, published in the Canadian Medical Association Journal, builds on more than 20 years of work by Dr. Bailey studying the impact of grapefruit juice on how certain drugs are metabolized.
“CBC came here and they did an interview in the lab, and it was on The National news broadcast. And then it went totally viral, including most major media in Canada, and there was also extensive coverage in the United States (ABC World News with Diane Sawyer, NBC), Europe, Australia and New Zealand. Was I surprised? Sure. Basically, we felt it was an important educational document for health-care professionals and were just glad to have it in a high impact journal.”
His research finding, as with so many major scientific discoveries, was stumbled upon by accident.
Bailey was originally investigating the impact of alcohol on a drug used to treat high blood pressure. The study was blinded – meaning the subjects could not know whether they were drinking alcohol or not – so he needed to find a mix that would mask the taste.
“I had already tried orange juice, which was no good, and all kinds of things like lemonade, grape juice, etc., and none of them worked. It was my wife Barbara who said, ‘There is a can of grapefruit concentrate in the freezer if you want to try that.’ And it worked.”
When he received the results of the study, one thing was unexpected. The level of drug in the blood was much higher than anticipated regardless of whether the subjects drank the alcohol or not. Was it because the subjects had received their medication with the grapefruit juice?
“So I decided to do a pilot study, on me, to find out. Once I took the drug with water, then I took it with grapefruit juice. My drug levels were five times higher with grapefruit juice,” he says. “That was a big eureka moment.”
The result was so unusual it was met by some with skepticism, even disbelief. However Dr. Bailey’s first major study on this interaction was published by the prestigious medical journal, The Lancet, in 1991. That led to a major story in the New York Times.
“The next big question has always been, ‘how relevant is this clinically?’. And there was always this argument, ‘so it boosts the level of the drug – so what’?”
Time and further study answered that question and lengthened the list of drugs impacted by grapefruit juice – some with serious, possibly even fatal, consequences. Bailey’s 2012 paper almost doubled the previous list of drugs he had identified to a total of 85, and the number of life-threatening drug interactions grew from 17 to the mid-40s.
That news caught the world’s attention. “The day the article first came out, I did nothing but answer the phone and do interviews and I was convinced the media calls would end that day. That proved not to be the case.”
Julia Capaldi, who has worked as a communication consultant with Lawson Health Research Institute for the last nine years, said “I have never seen a story get this kind of pick-up – over 1,200 hits worldwide. By the end Dr. Bailey didn’t want to hear from me anymore. He was exhausted from talking about this so much!”
The media requests still persist, which is fine with Dr. Bailey, since his primary purpose in publishing the study was to create awareness of an accidental discovery that is today saving lives. “This is my legacy paper, the most important thing I have ever written.”