In a new article published recently in Learning Health Systems, colleagues from the Pain Management Collaboratory examined challenges related to justice and equity in pragmatic clinical trials (PCTs) on pain management.

Based on our experience with PCTs in health systems that serve military and veteran populations,  we suggest it is particularly important to recognize that: (a) some individuals with chronic pain are vulnerable to injustice, (b) structural and sociocultural challenges that exist within health systems can complicate chronic pain research, and (c) PCTs involving NPTs [nonpharmalogical treatments] provide one lens through which injustices may be identified and addressed with the proactive input of a broad range of stakeholders.

Broadly engaging diverse stakeholders throughout the lifecycle of a PCT will take creativity, and the authors suggest specific strategies to enhance justice and equity for different phases of a PCT, including conduct and design, recruitment, selection and implementation of interventions, and stakeholder engagement .

Within learning health systems, principles of continuous learning and feedback to improve care can potentially be put to use not only to secure value in healthcare, but also to support evidence development to guide equitable practice.

Read the full article.