Despite convincing results for many health care interventions, translating evidence from research into clinical practice is often challenging. Implementation barriers are myriad and complex, but a number may arise from core design issues. While real-world environments are clearly vital to the success of any intervention, many traditional research efforts are structured to remove them from the proverbial equation.
In studying the impact of a new medication, for instance, a group might rigorously apply statistical methods to ensure that study results reflect the effect of the medication rather than of patient, study site, or other characteristics.
This makes sense for clinical studies in which the primary goal is to assess unbiased efficacy and understand how the medication fares regardless of patient and environmental influences. However, alternative approaches are needed for applied, “downstream” purposes, such as embedding medication use within a comprehensive wellness program or evaluating the best ways to promote adherence.
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