Pragmatic Trials

This chapter explores the role of pragmatic trialsPragmatic trials in agingAging researchResearch, comparing their characteristics to those of explanatory clinical trialsClinical trial. We additionally conducted an exploratory search of the literature up to February 2024 and identified 1613 records of pragmatic clinical trialsClinical trial involving older adultsOlder adults. There was a decline in publications during the COVID-19COVID-19 pandemic but an overall increase in trial registrations. The most frequently studied conditions were cancerCancer, pain, and diabetes. Most trials were conducted in high-income countries, highlighting the need to strengthen infrastructure, resources, and collaboration in low- to middle-income countries to conduct pragmatic trialsPragmatic trials that address the needs of geriatric patients worldwide. Pragmatic trialsPragmatic trials face unique ethical and methodological challenges, particularly in obtaining informed consent and ensuring the inclusion of older adultsOlder adults in explanatory trials for the subsequent ethical conduction of pragmatic trialsPragmatic trials. Tools such as PRECIS-2 and the GetReal Trial Tool can aid in designing trials that are both feasible and relevant to real-world practice. Pragmatic trialsPragmatic trials, with their focus on real-world effectivenessEffectiveness, play a crucial role in bridging the gap between researchResearch and clinical practice in the context of agingAging researchResearch.