Pragmatic Trials in Long-Term Care: Research Challenges and Potential Solutions in Relation to Key Areas of Care

Barbara Resnick*, Sheryl Zimmerman, Joseph Gaugler, Joseph Ouslander, Kathleen Abrahamson, Nicole Brandt, Cathleen Colón-Emeric, Elizabeth Galik, Stefan Gravenstein, Lona Mody, Philip D Sloane, Kathleen Unroe, Hilde Verbeek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


As a method of research, pragmatic trials are recommended so as to generate results that are applicable to real-world care. This intent is especially important for the millions of older adults who receive long-term care in thousands of nursing homes and assisted living communities across the country-and many millions more around the globe. This article presents key points raised by experts participating in a conference funded by the National Institute of Aging held at the 2021 conference of the Society for Post-Acute and Long-term Care Medicine. The purpose of the conference was to convene leading clinicians, researchers, and industry partners to address special considerations of pragmatic trials in long-term care. Cross-cutting and unique challenges and solutions to conducting pragmatic trials were discussed focusing on 3 areas of clinical relevance to long-term care: (1) functional care and outcomes, (2) psychosocial care and quality of life, and (3) medical care and outcomes, with a special focus on persons with dementia. Challenges and innovative solutions were organized across the 9 domains of the revised Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) Tool, and future research recommendations for pragmatic trials in long-term care were identified.

Original languageEnglish
Pages (from-to)330-338
Number of pages9
JournalJournal of the American Medical Directors Association
Issue number3
Publication statusPublished - Mar 2022


  • Aged
  • Humans
  • Long-Term Care
  • Nursing Homes
  • Quality of Life
  • Research Design
  • Pragmatic trials

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