ArticleAnnals of family medicine
Randomized controlled trials: do they have external validity for patients with multiple comorbidities?
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 129 papers, 11 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
129 citing papers in PubMed, 11 syntheses or guidelines pooled it.
- Frailty in randomised controlled trials for dementia or mild cognitive impairment measured via the frailty index: prevalence and prediction of serious adverse events and attrition.Alzheimer's research & therapy · 2023Pooled it
- A systematic review of interventions to support adults with ADHD at work-Implications from the paucity of context-specific research for theory and practice.Frontiers in psychology · 2022Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community setting: a systematic review.Systematic reviews · 2021Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2021Pooled it
- Clinical Trial Generalizability Assessment in the Big Data Era: A Review.Clinical and translational science · 2020Pooled it
- Exclusion rates in randomized controlled trials of treatments for physical conditions: a systematic review.Trials · 2020Pooled it
- Tramadol for osteoarthritis.The Cochrane database of systematic reviews · 2019Pooled it
- Celecoxib for osteoarthritis.The Cochrane database of systematic reviews · 2017Pooled it
- The role of diseases, risk factors and symptoms in the definition of multimorbidity - a systematic review.Scandinavian journal of primary health care · 2016Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2016Pooled it
- Managing patients with multimorbidity: systematic review of interventions in primary care and community settings.BMJ (Clinical research ed.) · 2012Pooled it
- Trial
- User Experience Affects Dropout from Internet-Delivered Dialectical Behavior Therapy.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2020Trial
- Trial
- Effectiveness of Two Web-Based Interventions for Chronic Cancer-Related Fatigue Compared to an Active Control Condition: Results of the "Fitter na kanker" Randomized Controlled Trial.Journal of medical Internet research · 2017Trial
- Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy: study protocol of a cluster randomized clinical trial (Multi-PAP project).Implementation science : IS · 2017Trial
- Trial
- International Generalist Physicians' Conceptions of Generalism: "The Way," "The Privilege," and "The Indescribable Whole".Annals of family medicine · 2026Article
- Patient-Centred Care for Multimorbid Patients: A Scoping Review.Journal of clinical medicine · 2026Review
- Article
69 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMany randomized controlled trials (RCTs) exclude patients who have multiple comorbidities. The aim of this study was to illustrate the prevalence of comorbidities among patients followed up in primary care who would have met the inclusion criteria of selected RCTs focusing on treatment of a particular condition. We used hypertension as an example of a particular chronic condition.
methodsWe used an existing database of 980 patients (660 women) that was representative of a population consulting primary care family doctors and that contained information about all chronic conditions. We randomly selected 5 RCTs that focused on patients with hypertension. The inclusion and exclusion criteria used in each of the 5 RCTs were applied (1 study at a time) to the patients in our database. The patients from our data set who met the inclusion criteria of a given RCT were considered eligible for that RCT.
resultsOf the patients from our data set who were eligible for each of the RCTs, 89% to 100% had multiple chronic conditions. The mean number of chronic conditions of patients eligible for each RCT ranged from 5.5 +/- 3.3 to 11.7 +/- 5.3.
conclusionsResults from this study suggest that RCTs targeting a chronic medical condition such as hypertension could find that, in a sample taken from family practice, most eligible patients have comorbid conditions. Whether these patients are sampled or excluded should be reported. Research results intended to be applied in medical practice should take the complex reality of effective treatment of these patients into consideration.
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