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Studies designed to provide insight into clinical practice in the real world are known as pragmatic trials. They are usually characterized by a focus on the practical aspects of the research design,
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A practical trial that employs various investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is required for
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The purpose of pragmatic trials is to mimic real-life scenarios and gain the highest level of validity externally. They are usually commissioned by policymakers and practitioners to help guide their decisions. They can also be used to assess the causality of an intervention and its results. However, they should not be used to substitute for the use of explanation studies.
The pragmatism idea is controversial and there are concerns about whether pragmatic trials can replace explanatory tests or if they are a complement to them. Schwartz and Lellouch1 made the distinction between explanation studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, which inform the decision-making process for policy and practice. They also suggested the framework for pragmatic trials, dubbed PRECIS.2 This tool attempted to define the elements of a pragmatic trial that include the recruitment process, the design and delivery of the intervention, and monitoring.
There is a growing trend in the number of pragmatic trials published. A recent Medline search using the keywords naturalistic and pragmatic, which was limited to controlled trials that are randomized (RCTs) resulted in 34 articles, as shown in red in Figure 2. This indicates that the health science community is becoming increasingly sensitized to the subject of pragmatic thinking. It is important to keep in mind that the majority of these trials were conducted in primary care settings.