Provider experiences with and attitudes about an embedded pragmatic clinical trial
Abstract Background/aims The Diuretic Comparison Project (DCP) was a pragmatic clinical trial comparing rates of cardiovascular events between hydrochlorothiazide or chlorthalidone. VA primary care providers (PCPs) and their patients were participants in the study. Veterans ≥ 65 years taking hydroch...
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BMC
2025-04-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-025-02799-w |
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| author | Sarah M. Leatherman Britte Beaudette-Zlatanova Gregory Robben Peter A. Glassman Patricia Woods Ryan E. Ferguson William C. Cushman Areef Ishani |
| author_facet | Sarah M. Leatherman Britte Beaudette-Zlatanova Gregory Robben Peter A. Glassman Patricia Woods Ryan E. Ferguson William C. Cushman Areef Ishani |
| author_sort | Sarah M. Leatherman |
| collection | DOAJ |
| description | Abstract Background/aims The Diuretic Comparison Project (DCP) was a pragmatic clinical trial comparing rates of cardiovascular events between hydrochlorothiazide or chlorthalidone. VA primary care providers (PCPs) and their patients were participants in the study. Veterans ≥ 65 years taking hydrochlorothiazide were randomized to continue on hydrochlorothiazide or switch to chlorthalidone. Participating providers could decline the randomization of their patients. Providers were surveyed about their experience with DCP, and to ascertain providers’ understanding of and attitudes towards embedded pragmatic trials. Methods A questionnaire was emailed to PCPs that provided informed consent to participate in the study. The survey asked about provider experience with the trial including interest in the study question, awareness of the study and educational materials, impact on the provider-patient relationship, burden of study participation, and their attitudes towards pragmatic trials. Respondents could also add free text comments. Results There were 180 completed surveys. Of those, most found the trial question of interest (91%) and found the time required to participate in the trial was reasonable (67%). Only 2 (1%) felt the study had a negative impact on the provider-patient relationship. 97% of providers were as comfortable with (59%) or more comfortable with (32%) DCP compared to traditional randomized controlled trials. Conclusion Responding providers’ experience with DCP and their attitudes towards pragmatic trials were positive. Primary care providers indicated willingness to participate in future pragmatic trials if burden is low and it does not negatively impact patient care. Results support continued use of pragmatic embedded clinical trials in primary care. Clinical trial registration NCT02185417. Registered 9 July 2014. https://clinicaltrials.gov/ct2/show/NCT02185417 . |
| format | Article |
| id | doaj-art-3ad6cab4ee3e458e941e16d6f532d0dd |
| institution | DOAJ |
| issn | 2731-4553 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-3ad6cab4ee3e458e941e16d6f532d0dd2025-08-20T03:15:12ZengBMCBMC Primary Care2731-45532025-04-012611910.1186/s12875-025-02799-wProvider experiences with and attitudes about an embedded pragmatic clinical trialSarah M. Leatherman0Britte Beaudette-Zlatanova1Gregory Robben2Peter A. Glassman3Patricia Woods4Ryan E. Ferguson5William C. Cushman6Areef Ishani7Cooperative Studies Program Coordinating Center, VA Boston Healthcare SystemCooperative Studies Program Coordinating Center, VA Boston Healthcare SystemCooperative Studies Program Coordinating Center, VA Boston Healthcare SystemPharmacy Benefits Management Services, Department of Veterans AffairsCooperative Studies Program Coordinating Center, VA Boston Healthcare SystemCooperative Studies Program Coordinating Center, VA Boston Healthcare SystemMedical Service, Memphis VA Medical CenterMinneapolis VA Healthcare SystemAbstract Background/aims The Diuretic Comparison Project (DCP) was a pragmatic clinical trial comparing rates of cardiovascular events between hydrochlorothiazide or chlorthalidone. VA primary care providers (PCPs) and their patients were participants in the study. Veterans ≥ 65 years taking hydrochlorothiazide were randomized to continue on hydrochlorothiazide or switch to chlorthalidone. Participating providers could decline the randomization of their patients. Providers were surveyed about their experience with DCP, and to ascertain providers’ understanding of and attitudes towards embedded pragmatic trials. Methods A questionnaire was emailed to PCPs that provided informed consent to participate in the study. The survey asked about provider experience with the trial including interest in the study question, awareness of the study and educational materials, impact on the provider-patient relationship, burden of study participation, and their attitudes towards pragmatic trials. Respondents could also add free text comments. Results There were 180 completed surveys. Of those, most found the trial question of interest (91%) and found the time required to participate in the trial was reasonable (67%). Only 2 (1%) felt the study had a negative impact on the provider-patient relationship. 97% of providers were as comfortable with (59%) or more comfortable with (32%) DCP compared to traditional randomized controlled trials. Conclusion Responding providers’ experience with DCP and their attitudes towards pragmatic trials were positive. Primary care providers indicated willingness to participate in future pragmatic trials if burden is low and it does not negatively impact patient care. Results support continued use of pragmatic embedded clinical trials in primary care. Clinical trial registration NCT02185417. Registered 9 July 2014. https://clinicaltrials.gov/ct2/show/NCT02185417 .https://doi.org/10.1186/s12875-025-02799-wPrimary carePragmatic clinical trialsProvider experienceEmbedded trialsHypertensionDiuretics |
| spellingShingle | Sarah M. Leatherman Britte Beaudette-Zlatanova Gregory Robben Peter A. Glassman Patricia Woods Ryan E. Ferguson William C. Cushman Areef Ishani Provider experiences with and attitudes about an embedded pragmatic clinical trial BMC Primary Care Primary care Pragmatic clinical trials Provider experience Embedded trials Hypertension Diuretics |
| title | Provider experiences with and attitudes about an embedded pragmatic clinical trial |
| title_full | Provider experiences with and attitudes about an embedded pragmatic clinical trial |
| title_fullStr | Provider experiences with and attitudes about an embedded pragmatic clinical trial |
| title_full_unstemmed | Provider experiences with and attitudes about an embedded pragmatic clinical trial |
| title_short | Provider experiences with and attitudes about an embedded pragmatic clinical trial |
| title_sort | provider experiences with and attitudes about an embedded pragmatic clinical trial |
| topic | Primary care Pragmatic clinical trials Provider experience Embedded trials Hypertension Diuretics |
| url | https://doi.org/10.1186/s12875-025-02799-w |
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