Pragmatic trial design enhances diversity and retention among research participants with Lewy body diseases

An ongoing pragmatic, randomized, unblinded clinical trial compares pimavanserin and quetiapine for psychosis in Lewy body diseases over 6 months (n = 60). Relative to local explanatory clinical trials, retention is higher (93% vs 40%, p < 0.001) and Hispanic enrollment greater (38% vs 21%, p = 0.043), reflecting the clinic demographics. Embedding pragmatic trials within routine care can enhance retention and diversity, thereby improving representativeness and real-world applicability of clinical research. Registry: ClinicalTrials.gov, TRN: NCT05590637; Registration Date: 18 October 2022.