TY - JOUR
T1 - Conducting a Pragmatic Trial in Integrated Primary Care
T2 - Key Decision Points and Considerations
AU - Kanzler, Kathryn E.
AU - McGeary, Donald D.
AU - McGeary, Cindy
AU - Blankenship, Abby E.
AU - Young-McCaughan, Stacey
AU - Peterson, Alan L.
AU - Buhrer, J. Christine
AU - Cobos, Briana A.
AU - Dobmeyer, Anne C.
AU - Hunter, Christopher L.
AU - Bhagwat, Aditya
AU - Star, John A.Blue
AU - Goodie, Jeffrey L.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/3
Y1 - 2022/3
N2 - Pragmatic trials testing the effectiveness of interventions under “real world” conditions help bridge the research-to-practice gap. Such trial designs are optimal for studying the impact of implementation efforts, such as the effectiveness of integrated behavioral health clinicians in primary care settings. Formal pragmatic trials conducted in integrated primary care settings are uncommon, making it difficult for researchers to anticipate the potential pitfalls associated with balancing scientific rigor with the demands of routine clinical practice. This paper is based on our experience conducting the first phase of a large, multisite, pragmatic clinical trial evaluating the implementation and effectiveness of behavioral health consultants treating patients with chronic pain using a manualized intervention, brief cognitive behavioral therapy for chronic pain (BCBT-CP). The paper highlights key choice points using the PRagmatic-Explanatory Continuum Indicator Summary (PRECIS-2) tool. We discuss the dilemmas of pragmatic research that we faced and offer recommendations for aspiring integrated primary care pragmatic trialists.
AB - Pragmatic trials testing the effectiveness of interventions under “real world” conditions help bridge the research-to-practice gap. Such trial designs are optimal for studying the impact of implementation efforts, such as the effectiveness of integrated behavioral health clinicians in primary care settings. Formal pragmatic trials conducted in integrated primary care settings are uncommon, making it difficult for researchers to anticipate the potential pitfalls associated with balancing scientific rigor with the demands of routine clinical practice. This paper is based on our experience conducting the first phase of a large, multisite, pragmatic clinical trial evaluating the implementation and effectiveness of behavioral health consultants treating patients with chronic pain using a manualized intervention, brief cognitive behavioral therapy for chronic pain (BCBT-CP). The paper highlights key choice points using the PRagmatic-Explanatory Continuum Indicator Summary (PRECIS-2) tool. We discuss the dilemmas of pragmatic research that we faced and offer recommendations for aspiring integrated primary care pragmatic trialists.
KW - Chronic pain
KW - Dissemination and implementation science
KW - Pragmatic trials
KW - Primary care
KW - Primary care behavioral health
UR - http://www.scopus.com/inward/record.url?scp=85107572044&partnerID=8YFLogxK
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U2 - 10.1007/s10880-021-09790-4
DO - 10.1007/s10880-021-09790-4
M3 - Article
C2 - 34100153
AN - SCOPUS:85107572044
SN - 1068-9583
VL - 29
SP - 185
EP - 194
JO - Journal of Clinical Psychology in Medical Settings
JF - Journal of Clinical Psychology in Medical Settings
IS - 1
ER -