The interventions tested in pragmatic clinical trials are embedded into routine care practices, which offers opportunities to study implementation and sustainment outcomes.
In an article published online ahead of print in Implementation Science Communications, members of the NIH Pragmatic Trials Collaboratory’s Implementation Science Core share the results of a survey about the measurement of implementation outcomes in pragmatic trials.
Of the 32 NIH Collaboratory Trials, 29 completed the survey (91% response rate).
Main findings:
Across the trials, measurement was high for some constructs, including:
- Reach (91%)
- Adherence (76%)
- Fidelity (93%)
- Adaptations (69%)
However, evaluation for some constructs remains low:
- Costs (31%)
- Clinician adoption and representativeness (45%)
- Anticipated sustainment (24%)
- Actual sustainment (38%)
The authors suggest there is opportunity for growth in measuring some of these important implementation constructs.
“To benefit from the substantial investment into pragmatic clinical trials, we need to improve measurement of constructs that drive the implementation of evidence into routine care, including information about costs, sustainability, and sustainment,” the authors wrote.
Measurement of these constructs in future pragmatic trials could result in development of improved implementation strategies to increase the likelihood of effective implementation leading to equitable, sustainable, and scalable improvement in practice.
For more information about implementation in pragmatic clinical trials, see the Living Textbook Chapter on Implementation.