{"doi":"10.1093/pm/pnae055","title":"Engaging clinical partners in pragmatic clinical trials: lessons learned from the pain management collaboratory","abstract":"The Pain Management Collaboratory (PMC) is an innovative intergovernmental agency trial network. The PMC supports 13 pragmatic clinical trials (PCTs) evaluating nonpharmacological approaches to management of pain and common co-occurring conditions in military and veteran healthcare systems.1 Beginning in 2018, the cross-trial PMC Stakeholder Engagement Working Group has identified important research stakeholders and anticipate potential challenges of working with these diverse individuals and groups.2 We have since changed the term “stakeholders” to “partners” because while the former term underplays the critical role of personnel with vested interests in study performance and results, the latter term recognizes the vital importance of these individuals for the success of research projects and implementation of findings.3 Although longstanding efforts within the pain scientific community have emphasized the value of listening to the voices of people with lived experience to guide research that will yield medically and culturally relevant results, these efforts have focused on patients, caregivers, and families. Herein we discuss how PMC investigators engaged with clinical partners who participated in these pragmatic trials over the past 5 years. This Commentary describes barriers we have encountered and strategies to address partnerships within military and veteran health settings across 3 domains: Sustainable connections with clinical personnel, patient-centered research infrastructure, and building relationships with administrators (see Table 1). Engaging clinical partners in pragmatic clinical trials: Barriers and solutions. There are many roles and opportunities for clinical partners to participate in pragmatic trials. These include serving as a research facilitator,4 caring for patients according to an established research protocol, and referring potential research participants to study investigators. Other potential roles for clinical partners include sharing clinical responsibilities when possible and providing practical insights for pragmatic trial researchers planning studies that reflect and address real-life conditions. Clinical staff availability to participate in pragmatic research is a significant issue in health settings that serve military members and veterans. Ongoing conversations with PMC trial teams have pointed to frequent turnover of military clinicians in Department of Defense (DOD)-funded trials—and within Department of Veterans Affairs (VA)-funded trials, a shortage of clinicians to participate in research due to heavy patient loads and insufficient back-up support. Limitations in clinical staff availability to participate in pragmatic research are exacerbated by administrative delays to replace and onboard key clinical staff. As one way to address these issues, several PMC trials developed mentorship programs whereby personnel from sites meeting ongoing recruitment targets and other milestones helped to onboard and mentor clinical personnel at other study sites. These personnel included clinic providers, research personnel, technicians, and front desk staff. PMC trial leaders hired appropriately credentialed research clinicians to deliver virtual interventions or to offset clinician workload by caring for patients who were not enrolled in the study. PMC teams also worked to ensure that trial interventions counted toward a provider’s workload. Clinicians who deliver care in military and veteran health facilities often have multiple roles and responsibilities and are not compensated financially for participating in research. PMC investigators observed clinicians’ altruistic motivations to participate in clinical research can be weakened by additional burdens, such as institutional review board (IRB)-related paperwork and required training for working with human research participants.5 To address these issues, some PMC teams have created mechanisms to streamline required research training and/or offer it","journal":"Pain Medicine","year":2024,"id":471351,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9553,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":242821,"name":"Steven P. Cohen","orcid":"0000-0001-5928-2127","position":1,"is_corresponding":false},{"id":360894,"name":"Stacie A. Salsbury","orcid":"0000-0002-9668-2426","position":2,"is_corresponding":false},{"id":793957,"name":"Alison F. Davis","orcid":"0000-0002-8610-6580","position":3,"is_corresponding":false},{"id":362633,"name":"Lily Katsovich","orcid":null,"position":4,"is_corresponding":false},{"id":431791,"name":"Robert D. Kerns","orcid":"0000-0002-3834-973X","position":5,"is_corresponding":false},{"id":360883,"name":"Lori A. Bastian","orcid":"0000-0003-2874-6405","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-19T02:05:44.736405Z","pmid":"38954840","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}