Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems
Abstract Introduction Pragmatic clinical trials (PCTs) can overcome implementation challenges for bringing evidence‐based therapies to people living with pain and co‐occurring conditions, providing actionable information for patients, providers, health systems, and policy makers. All studies, includ...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-04-01
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| Series: | Learning Health Systems |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lrh2.10291 |
| _version_ | 1818018951067598848 |
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| author | Joseph Ali Alison F. Davis Diana J. Burgess Daniel I. Rhon Robert Vining Stacey Young‐McCaughan Sean Green Robert D. Kerns |
| author_facet | Joseph Ali Alison F. Davis Diana J. Burgess Daniel I. Rhon Robert Vining Stacey Young‐McCaughan Sean Green Robert D. Kerns |
| author_sort | Joseph Ali |
| collection | DOAJ |
| description | Abstract Introduction Pragmatic clinical trials (PCTs) can overcome implementation challenges for bringing evidence‐based therapies to people living with pain and co‐occurring conditions, providing actionable information for patients, providers, health systems, and policy makers. All studies, including those conducted within health systems that have a history of advancing equitable care, should make efforts to address justice and equity. Methods Drawing from collective experience within pragmatic pain clinical trials networks, and synthesizing relevant literature, our multidisciplinary working group examined challenges related to integrating justice and equity into pragmatic pain management research conducted in large, integrated health systems. Our analysis draws from military and veteran health system contexts but offers strategies to consider throughout the lifecycle of pragmatic research more widely. Results We found that PCTs present a unique opportunity to address major influences on health inequities by occupying a space between research, healthcare delivery, and the complexities of everyday life. We highlight key challenges that require attention to support complementary advancement of justice and equity via pragmatic research, offering several strategies that can be pursued. Conclusions Efforts are needed to engage diverse stakeholders broadly and creatively in PCTs, such as through dedicated health equity working groups and other collaborative relationships with stakeholders, to support robust and inclusive approaches to research design and implementation across study settings. These considerations, while essential to pain management research, offer important opportunities toward achieving more equitable healthcare and health systems to benefit people living with pain and co‐occurring conditions. |
| first_indexed | 2024-04-14T07:46:30Z |
| format | Article |
| id | doaj.art-c7c15f35c92047a4ad39d483782a8918 |
| institution | Directory Open Access Journal |
| issn | 2379-6146 |
| language | English |
| last_indexed | 2024-04-14T07:46:30Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Learning Health Systems |
| spelling | doaj.art-c7c15f35c92047a4ad39d483782a89182022-12-22T02:05:20ZengWileyLearning Health Systems2379-61462022-04-0162n/an/a10.1002/lrh2.10291Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systemsJoseph Ali0Alison F. Davis1Diana J. Burgess2Daniel I. Rhon3Robert Vining4Stacey Young‐McCaughan5Sean Green6Robert D. Kerns7Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USAPain Management Collaboratory, Department of Psychiatry Yale University School of Medicine New Haven Connecticut USAVA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Medical Center Minneapolis Minnesota USABrooke Army Medical Center and Uniformed Services University of the Health Sciences Fort Sam Houston Texas USAPalmer Center for Chiropractic Research, Palmer College of Chiropractic Davenport Iowa USAThe University of Texas Health Science Center Houston Texas USAPain Management Collaboratory, Department of Psychiatry Yale University School of Medicine New Haven Connecticut USADepartments of Psychiatry, Neurology, and Psychology Yale University New Haven Connecticut USAAbstract Introduction Pragmatic clinical trials (PCTs) can overcome implementation challenges for bringing evidence‐based therapies to people living with pain and co‐occurring conditions, providing actionable information for patients, providers, health systems, and policy makers. All studies, including those conducted within health systems that have a history of advancing equitable care, should make efforts to address justice and equity. Methods Drawing from collective experience within pragmatic pain clinical trials networks, and synthesizing relevant literature, our multidisciplinary working group examined challenges related to integrating justice and equity into pragmatic pain management research conducted in large, integrated health systems. Our analysis draws from military and veteran health system contexts but offers strategies to consider throughout the lifecycle of pragmatic research more widely. Results We found that PCTs present a unique opportunity to address major influences on health inequities by occupying a space between research, healthcare delivery, and the complexities of everyday life. We highlight key challenges that require attention to support complementary advancement of justice and equity via pragmatic research, offering several strategies that can be pursued. Conclusions Efforts are needed to engage diverse stakeholders broadly and creatively in PCTs, such as through dedicated health equity working groups and other collaborative relationships with stakeholders, to support robust and inclusive approaches to research design and implementation across study settings. These considerations, while essential to pain management research, offer important opportunities toward achieving more equitable healthcare and health systems to benefit people living with pain and co‐occurring conditions.https://doi.org/10.1002/lrh2.10291equityethicsjusticepain managementpragmatic clinical trial |
| spellingShingle | Joseph Ali Alison F. Davis Diana J. Burgess Daniel I. Rhon Robert Vining Stacey Young‐McCaughan Sean Green Robert D. Kerns Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems Learning Health Systems equity ethics justice pain management pragmatic clinical trial |
| title | Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems |
| title_full | Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems |
| title_fullStr | Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems |
| title_full_unstemmed | Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems |
| title_short | Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems |
| title_sort | justice and equity in pragmatic clinical trials considerations for pain research within integrated health systems |
| topic | equity ethics justice pain management pragmatic clinical trial |
| url | https://doi.org/10.1002/lrh2.10291 |
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