Ethical considerations within pragmatic randomized controlled trials in dementia: Results from a literature survey

INTRODUCTION: This review aims to describe the landscape of pragmatic randomized controlled trials (RCTs) in the context of Alzheimer's disease (AD) and related dementias with respect to ethical considerations. METHODS: Searches of MEDLINE were performed from January 2014 until April 2019. Extracted information included: trial setting, interventions, data collection, study population, and ethical protections (including ethics approvals, capacity assessment, and informed consent). RESULTS: We identified 62 eligible reports. More than two‐thirds (69%) included caregivers or health‐care professionals as research participants. Fifty‐eight (94%) explicitly identified at least one vulnerable group. Two studies did not report ethics approval. Of 57 studies in which patients were participants, 55 (96%) reported that consent was obtained but in 37 studies (67%) no mention was made regarding assessment of the patients’ capacity to consent to research participation. DISCUSSION: Few studies reported protections implemented when vulnerable participants were included. Shortcomings remain when reporting consent approaches and capacity assessment.