Res Gerontol Nurs. 2020 May 1;13(3):125-129. doi: 10.3928/19404921-20191127-01. Epub 2019 Dec 13.
Pragmatic trials occur within the complexity of real-world care delivery, and when effective, contribute to more rapid translation into practice because of their greater generalizability. Research with older adults is complex when participants have chronic conditions and multiple comorbidities. Often pragmatic trials introduce a novel intervention and try to determine whether it offers a benefit beyond the usual or routine care provided. Researchers commonly focus attention on describing the intervention, yet the comparator condition of usual or routine care can be anything but standard, reducing the effect size of the intervention and introducing threats to the overall validity of the study. The current article describes clinical trial guidelines, then illustrates the complexity of characterizing usual care for interventions addressing type 2 diabetes. The authors provide recommendations for improving description of usual care and discuss implications for gerontological nursing research. [Research in Gerontological Nursing, 13(3), 125-129.].
实用临床试验是在真实医疗环境下进行的，当它们有效时，由于其更强的普遍性，有助于更快地转化为实践。当参与者患有慢性疾病和多种合并症时，针对老年人的研究就变得复杂了。通常，实用临床试验引入新的干预措施，并试图确定它是否提供了比通常或常规护理更好的效果。研究人员通常关注描述干预措施，但通常或常规护理的对照条件可能并非标准，这会降低干预措施的效果大小，并对研究的整体有效性构成威胁。本文描述了临床试验指南，然后说明了描述 2 型糖尿病干预措施的常规护理的复杂性。作者为改善常规护理的描述提供了建议，并讨论了对老年护理研究的影响。[老年护理研究，13(3)，125-129。]。
