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Real-world Evidence versus Randomized Controlled Trial: Which is Suitable for Low and Middle-income Countries?
Deepak Y Kamath 1 2, K B Bhuvana 1, Luke Joshua Salazar 3, Kiron Varghese 4, Anant Kamath 5, Jyoti Idiculla 6, Prem Pais 2, Shruthi Kulkarni 6, Bradi B Granger 7, Denis Xavier 1 2 Abstract
Background: Prior reports have documented extremely poor adherence to evidence-based medications among South Asian patients with established chronic cardiovascular diseases. Treatment adherence is now considered a part of the 'self-care' process, the determinants of which have not been adequately explored or explained among South Asian patients with chronic heart failure (CHF). Our objective was to qualitatively ascertain the determinants of the self-care process among Indian patients with a lived experience of heart failure.
Methods: We conducted in-depth interviews (audio-recorded) among 22 purposively sampled patients living with chronic heart failure, diagnosed at least 4 weeks prior to the interview and 17 caregivers (n = 39) in a tertiary care teaching hospital in Southern India. We employed an inductive analytical approach using Charmaz's constructivist grounded theory. Initial line-by-line coding and categorization was followed by memo writing, reflexive analysis after interviewing and analyzing four, eight and twelve patients, and at each stage further theoretical sampling was carried out until we reached thematic saturation. We used NVivo ver. 12 to analyze and organize data.
