Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems.
Justice and equity in pragmatic clinical trials: Considerations for pain research within integrated health systems.
复制标题
DOI：
10.1002/lrh2.10291
复制
发表时间：
2022-04
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
作者：
实用临床试验 (PCT) 可以克服实施挑战，为患有疼痛和并发疾病的人们提供基于证据的治疗，为患者、提供者、卫生系统和政策制定者提供可操作的信息。所有研究，包括在具有促进公平医疗历史的卫生系统内进行的研究，都应努力解决正义和公平问题。我们的多学科工作组借鉴实用疼痛临床试验网络的集体经验，并综合相关文献，研究了将正义和公平纳入大型综合卫生系统中进行的实用疼痛管理研究中所面临的挑战。我们的分析借鉴了军事和退伍军人卫生系统的背景，但提供了在更广泛的务实研究的整个生命周期中考虑的策略。我们发现，PCT 占据了研究、医疗保健服务和日常生活复杂性之间的空间，为解决对健康不平等的重大影响提供了独特的机会。我们强调了需要关注的关键挑战，通过务实的研究支持正义和公平的互补性进步，并提供了几种可以采取的策略。需要努力让不同的利益相关者广泛、创造性地参与 PCT，例如通过专门的健康公平工作组和与利益相关者的其他合作关系，以支持跨研究环境的研究设计和实施的稳健和包容性方法。这些考虑因素虽然对疼痛管理研究至关重要，但也为实现更公平的医疗保健和卫生系统提供了重要机会，以使患有疼痛和并发疾病的人们受益。
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. 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. 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. 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.
登录
查看更多内容
影响因子：
3.1
作者：
Higgins, Diana M.;Kerns, Robert D.;Goulet, Joseph L.
通讯作者：
Goulet, Joseph L.
CDC规定慢性疼痛的阿片类药物的指南 - 美国，2016年。
DOI：
10.1001/jama.2016.1464
发表时间：
2016-04-19
期刊：
JAMA
影响因子：
--
作者：
Dowell D;Haegerich TM;Chou R
通讯作者：
Chou R
通过非药物治疗来控制虚拟分娩以管理慢性疼痛：对务实研究的影响。
影响因子：
7.4
作者：
Fritz JM;Davis AF;Burgess DJ;Coleman B;Cook C;Farrokhi S;Goertz C;Heapy A;Lisi AJ;McGeary DD;Rhon DI;Taylor SL;Zeliadt S;Kerns RD
通讯作者：
Kerns RD
影响因子：
3.1
作者：
Burgess, Diana J.;Evans, Roni;Taylor, Brent C.
通讯作者：
Taylor, Brent C.
影响因子：
4
作者：
Blakey, Shannon M.;Wagner, H. Ryan;Elbogen, Eric B.
通讯作者：
Elbogen, Eric B.