Attitudes of medical students to placebo therapy

Lim, Erle C.H.; Seet, Raymond C. S.

doi:10.1111/j.1445-5994.2007.01264.x

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…Six studies did not address definitional issues in the publication and probably in the questionnaire but five of these clearly focused on pure placebos [18-21,31], while some of the questions in one survey also addressed impure placebos [27]. Nine studies included explicit definitions or explanations in questionnaires or interviews for clarification [23,28-30,32,34-37]. One of these explicitly asked participants not to proceed with the questionnaire if they disagreed with the definition [30].…”

Section: Resultsmentioning

confidence: 99%

Frequency and circumstances of placebo use in clinical practice - a systematic review of empirical studies

Fässler

Meißner

Schneider

et al. 2010

BMC Med

175

202

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BackgroundThe use of placebo interventions outside clinical trials is ethically, professionally and legally controversial. Little is known about the frequency and circumstances of placebo use in clinical practice. Our aim was to summarize the available empirical studies addressing these issues.MethodsWe searched PubMed and EMBASE from inception to July 2009 in order to identify cross-sectional surveys, qualitative or longitudinal studies among health care professionals, students or patients which investigated at least one of the following issues - frequency of placebo use or attitudes to, or motivations for, the use of placebo interventions. At least two reviewers extracted information on the study methods, participants and findings. Descriptive summaries were prepared in an iterative process by at least two reviewers per study.ResultsTwenty-two studies from 12 different countries met the inclusion criteria. Most studies had relevant shortcomings. The proportion of respondents reporting that they had applied 'pure' placebos (for example, saline injection) during their professional life varied between 17% and 80% among physicians and between 51% and 100% among nurses, but it seems that the actual frequency of such use seems to be rare. The use of 'impure' or 'active' placebos (for example, antibiotics for viral infections) is likely to be much more frequent. However, it is impossible to make a reliable estimation because there is no agreement of what an impure placebo might be. Studies using qualitative methods or asking participants to judge case examples suggest that motivations and attitudes towards placebo use are complex and health care providers are often faced with a dilemma.ConclusionsAlthough the available evidence is incomplete and confusing at times there can be little doubt that the prevalence of placebo use outside of clinical trials is not negligible and that views and attitudes on placebos use differ considerably among individuals, both health care professionals and patients. Further research is needed to clarify these issues.

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Section: Resultsmentioning

confidence: 99%

Frequency and circumstances of placebo use in clinical practice - a systematic review of empirical studies

Fässler

Meißner

Schneider

et al. 2010

BMC Med

175

202

View full text Add to dashboard Cite

show abstract

“…Non-respondents and missing data may have led to possible biases. Other surveys about placebo use also had response rates under 60% [ 10 , 12 , 23 , 26 ], which may well have its reasons in the somewhat delicate nature of the topic on the one hand and the high workloads of practicing physicians on the other, reducing the readiness to participate in research [ 27 ]. A formal testing of differences in age and gender for respondents and non-respondents cannot be presented for our study because we did not collect these data from non-respondents.…”

Section: Discussionmentioning

confidence: 99%

Use of placebo interventions among Swiss primary care providers

Fässler

Gnädinger

Rosemann

et al. 2009

BMC Health Serv Res

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“…The recommendations should include clear definitions to avoid conceptual confusion and should relate to findings of placebo research to compensate for a possible lack of understanding of the placebo effect. 11,[14][15]28,30,31 Such professional standards could…”

Section: Implications For Future Research and Clinical Practicementioning

confidence: 99%

Placebo interventions in practice: a questionnaire survey on the attitudes of patients and physicians

Fässler¹,

Gnädinger²,

Rosemann³

et al. 2011

Br J Gen Pract

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BackgroundFew studies have investigated whether patients and physicians differ in their attitudes regarding placebo interventions in medical practice. AimTo compare the proportions of patients and physicians who would accept therapies that do not work through specific pharmacological or physiological action but by enhancing self-healing capacities and by exploiting contextual factors. Design of studySurvey of a random sample of GPs and patients consecutively attending in primary care practices. SettingFour hundred and seventy-seven patients and 300 GPs from primary care practices of the Canton Zurich of Switzerland were approached. MethodTwo questionnaires on responders' attitudes regarding non-specific therapies. ResultsThe response rates were 87% for patients and 79% for GPs. Eighty-seven per cent of patients and 97% of GPs thought that physical complaints can get better by believing in the effectiveness of the therapy. Overall there was more support for placebo interventions among patients than among GPs, yet 90% of the physicians admitted to actively proposing treatments intended to take advantage of non-specific effects. Seventy per cent of the patients wanted to be explicitly informed when receiving a non-specific intervention, whereas physicians thought this was the case for only 33% of their patients. Fifty-four per cent of patients would be disappointed when learning they had unknowingly been treated with pure placebo ('sugar pill'), while only 44% would feel that way after treatment with impure placebo (for example, herbal medicine). ConclusionGPs rather underestimate the openness of their patients to non-specific therapies. However, patients want to be appropriately informed. Developing specific professional standards could help physicians to harness the 'power of the placebo', while remaining authentic and credible.

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Attitudes of medical students to placebo therapy

Abstract: Our medical students felt that placebo therapy is acceptable in certain situations. We identified their erroneous acceptance of placebo therapy in organic diseases, for which there is established treatment, as an area to be addressed in our undergraduate curriculum.

Cited by 8 publications

References 16 publications

Frequency and circumstances of placebo use in clinical practice - a systematic review of empirical studies

Frequency and circumstances of placebo use in clinical practice - a systematic review of empirical studies

Use of placebo interventions among Swiss primary care providers

Placebo interventions in practice: a questionnaire survey on the attitudes of patients and physicians

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