title: Issues in conducting randomized controlled trials of health services research interventions in nonacademic practice settings: the case of retail pharmacies.
abstract: OBJECTIVE
  To describe unexpected challenges and strategies to overcome them when conducting randomized controlled trials (RCT) of health services research interventions in retail pharmacies.
  
  
  METHODS
  Thirty-six retail drug stores in Indianapolis.
  
  
  METHODS
  We conducted an RCT to evaluate the effectiveness of an intervention to increase pharmacists' involvement in caring for customers. We describe: (1) our RCT as originally designed, (2) unexpected challenges we faced; and (3) how we resolved those challenges.
  
  
  METHODS
  Randomized controlled trial.
  
  
  RESULTS
  Major modifications in research design were necessitated by factors such as corporate restructuring, heightened sensitivity to patient confidentiality, and difficulties altering employees' behavior. We overcame these barriers by conducting research that is consistent with corporate goals, involving appropriate corporate administrators and technical personnel early in the process, and being flexible.
  
  
  CONCLUSIONS
  Health services researchers should conduct RCTs in a variety of non-academic practice settings to increase generalizability and better reflect the true impact of interventions. Pragmatic problems, although significant, can be successfully overcome.
authors.affiliation: Indiana University Schol of Medicine, USA.
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Michael D
authors.initials: MD
authors.lastname: Murray
authors.forename: David G
authors.initials: DG
authors.lastname: Marrero
authors.forename: Nancy
authors.initials: N
authors.lastname: Brewer
authors.forename: Michael
authors.initials: M
authors.lastname: Lykens
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Harris
authors.forename: A Jeffrey
authors.initials: AJ
authors.lastname: Newell
authors.forename: Joyce
authors.initials: J
authors.lastname: Collins
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
mesh_terms: D000293:Adolescent; D000328:Adult; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D010348:Patient Care Team; D010594:Pharmacies / Q000458:organization & administration*; D010595:Pharmacists; D024382:Professional Role; D012107:Research Design