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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are typically described as focusing on practical aspects of designing a study, including the recruitment and consent process, as well as adherence and the use of routinely available equipment.

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A practical trial that employs different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, which is vital for a pragmatic trial to be valid and lessen the chance of bias is also essential. Too much heterogeneity, however, can cause problems with the trial design.

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The goal of pragmatic trials is to simulate real-life scenarios and to achieve maximum validity externally. They are usually commissioned by practitioners and policy makers to guide their decision-making. They can also be a great method of determining the causality between an intervention and its results. However, they should not be used to substitute for explanatory trials.

The pragmatism idea is controversial, and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm a physiological or clinical hypothesis as well as pragmatic trials, which guide the policy and practice of. They also suggested a framework for pragmatic trials, called PRECIS.2 This tool attempted to define the elements of a pragmatic study that include the recruitment process, the design and delivery of the intervention, and the follow-up.

The number of pragmatic trials is growing. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This is a sign that the health sciences community is becoming more sensitive to the subject of pragmatics. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.