The Use of Placebo Interventions in Medical Practice—A National Questionnaire Survey of Danish Clinicians

Abstract

The authors sent a questionnaire to 772 randomly selected Danish clinicians and asked them about their use of placebo interventions. Sixty-five percent responded. Among the general practitioners, 86% (95% confidence interval 81-91) reported to have used placebo interventions at least once, and 48% (41-55) to have used placebo interventions more than ten times, within the last year. Hospital-based doctors and private specialists reported to have used placebo interventions less frequently (p < .001). The most important reason for the use of placebo interventions was to avoid a confrontation with the patient. Typical placebos were antibiotics for viral infections. Approximately 30% (28-36) of the clinicians believed in an effect of placebo interventions on objective outcomes, and 46% (42-50) found clinical placebo interventions generally ethically acceptable.

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

“…7 Applying the concept of pure and impure placebos to the examples given in other studies confirms that physicians hesitate to use pure placebos and tend to use impure placebos. 5,6,[8][9][10][11][12][13]28 However, no other studies were found that directly investigated attitudes towards pure versus impure placebos. Many treatments can be considered as impure placebos; for example, medications with proven benefit for another indication than the present one, or herbal medicines without evidence of pharmacological effectiveness.…”

“…During the last 20 years, eight questionnaire studies have demonstrated a wide variety of physicians' attitudes and opinions on the use of placebo interventions in day-to-day practice. [5][6][7][8][9][10][11][12] Physicians are more hesitant to use pure placebos (for example, a sugar pill or an injection with saline solution) than impure placebos (substances or methods that do have a known pharmacological or physical action but that cannot be expected to have any direct therapeutic effects for the respective disease and in the chosen dosage). 7,13 The published surveys suggest that many physicians are aware of beneficial placebo or context effects but are unsure how to use them in a nondeceptive manner.…”

Placebo interventions, placebo effects and clinical practice

“…Surveys show that the non-indicated use of active drugs is much more frequent than the use of pure placebos [11,13,14]. Qualitative interview studies addressing the prescribing of antibiotics in uncomplicated upper respiratory tract infections have shown that physicians are aware of the problems of their behaviour in such situations, but the word placebo does not come up [15,16].…”

Placebo Effect of Saline in Pain Management: Compared Study with Hemodialysis and Non-hemodialysis Nurses' Experiences

“…[2] For over 500 Danish physicians who responded to a questionnaire, placebo use was as high as 86% among general practitioners, 54% among hospital-based physicians, and 41% of private specialists. [11] In Chicago, 45% of 231 internists affiliated with three local medical schools admitted to using the placebo. [12] In another study in Israel, they questioned 90 physicians and nurses in primary and tertiary care and found that 60% used the placebo.…”