Title: Pragmatic Research in Health Service

Biography:

Prof. DR. Manjubala Dash, working as a professor in Nursing. Speciality is obstetric and Gynaecological Nursing. Have 21 years of teaching and research experience in the field of Nursing.  She is organized National and International Conferences, workshops in the field of Nursing.  Participated and presented more than 100 papers in the National and  International conferences. Published articles nearly 50 in the National and International Journals.  She is the co-editor for International  Journal of Nursing Panorama, The Genesis, Contemporary Journal of Microbiology, EC Paediatrics, EC Gynaecology etc. she has credit of  3 books in the field of Midwifery and Word management. Contributed chapters for Midwifery Books. She is a National  Trainer for Infant and Young Child Feeding Counselling Specialit course. Did research projects under DHR and ICMR, DST etc. Main interest is on Research, Education and Administration. Conducted many programmers for antenatal, postnatal mothers in the community level and hospital level. Got opportunity to deliver a talk as speaker in the International and National Conferences. She is guiding the Students of UG, PG and PhD for Research.  She has a recognized guide in different university and examiner for PG and PhD Students too. She have gone for conducting Inspections to various colleges by the Indian Nursing Council.  Her special interest is on family planning, contraceptive methods, reproductive health, promote exclusive breast feeding etc. 

Abstract

Pragmatic research is designed with input from health systems—and produces evidence that can be readily used to improve care. By engaging health systems, providers, and patients as partners, pragmatic research accelerates the integration of research, policy, and practice.

Pragmatic clinical trials (PCTs) are designed to improve practice & policy.  Unlike most traditional RCTs, they take place in settings where everyday care happens, such as community clinics, hospitals, and health systems.  Collaborating providers and organizations are integral partners and gain practical evidence on how to improve patient health and satisfaction.  Pragmatic partnerships engage at multiple levels – including patients, practitioners, teams, health systems and communities

Core characteristics of pragmatic clinical trials (PCTs

·         Questions from and important to stakeholders

·         Diverse, representative populations

·         Multiple, heterogeneous settings

·         Multiple outcomes important to decision and policy makers

·         Comparison conditions are real-world alternatives, not a placebo or no treatment

 

Key differences between RCTs &PCTs	RCTs	PCTs
	A traditional RCT tests a hypothesis under ideal conditions	A PCT compares treatments under everyday clinical conditions
GOALS	To determine causes and effects of treatment	To improve practice and inform clinical & policy decisions
DESIGN	Tests the intervention against placebo using rigid study protocols & minimal variation	Tests two or more real-world treatments using flexible protocols & local customization
PARTICIPANTS	Highly defined & carefully selected	More representative because eligibility criteria are less strict
MEASURES	Require data collection outside routine clinical care	Brief and designed so data can be easily collected in clinical settings
RESULTS	Rarely relevant to everyday practice	Useful in everyday practice, especially clinical decision making

 

 

 

 

 

 

Advantages of Pragmatic Clinical Trials

Practical

• Designed to test what will work in everyday care, with emphasis on successful implementation.

Inclusive

• PCTs study diverse populations receiving care in real world settings using broadly inclusive criteria for study participation.

Engaged

 • Health systems, providers, and patients are involved in study design, collecting data, interpreting results, and acting on findings. 

Relevant

• Results designed to directly inform decision-making of administrators, providers, patients, and policymakers.

Benefits of PCTs for healthy systems & providers

Actionable- Designed around application to practice, with an emphasis on successful implementation

Patient-centered- Research questions and goals are strongly aligned with patientcentered research and care.

Relevant- Transparent reporting of results that are focused on issues and data that are relevant for making decisions and taking action.

Conclusion

Pragmatism approach in research is a reasonable and logical way of doing things or of thinking about problems that is based on dealing with specific situations instead of on ideas and theories. It is a practical approach to problems and affairs tried to strike a balance between principles and pragmatism. health care organizations as research partners in large-scale studies designed to yield results relevant to clinical practice.The Health Care Systems Research Collaboratory…will move us beyond traditional randomized clinical trials to more broad-based, real world settings