Pragmatic Trials and Improving Long-Term Care: Recommendations From a National Institutes of Health Conference

Conducting clinical trials in nursing homes, assisted living, and other long-term settings is attendant with challenges, including but not limited to recruitment and retention of settings, participant attrition, staff time constraints, family resistance, research ethics concerns, burdensome implementation and measurement, cost, and mistrust.1–7 For these reasons and also because research protocols may dictate exclusionary eligibility criteria, participation rates may be low, data may be incomplete, and results may not be generalizable.