Use of Placebos in Medical Practice

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

“…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 ].…”

The Effect of Question Wording in Questionnaire Surveys on Placebo Use in Clinical Practice

“…The frequency of use of placebo intervention reported in this study was also among the highest yet reported, but not the very highest. In the group that was asked explicitly about the use of placebo interventions, 60% of respondents declared at least monthly use, whereas in American studies, the corresponding rates were 80% (Tilburt et al, 2008) and 8% (Sherman & Hickner, 2008), and in German studies, 70% (Classen & Feingold, 1985) and 13% (Bernateck et al, 2009).…”

“…In a recent review, Fässler, Meissner, Schneider, and Linde (2010) identified 23 publications that presented the results of research aimed at defining the scope and frequency of placebo interventions by physicians and nurses, and also—much more rarely—by medical interns, medical students, and patients, as well as the circumstances that surrounded and attitudes toward such interventions (Berger, 1999; Bernateck et al, 2009; Berthelot, Maugars, Abgrall, & Prost, 2001; Chen & Johnson, 2009; Classen & Feingold, 1985; Comaroff, 1976; Ernst & Abbot, 1997; Fässler, Gnädinger, Rosemann, & Biller-Andorno, 2009; Goldberg, Leigh, & Quinlan, 1979; Goodwin, Goodwin, & Vogel, 1979; Gray & Flynn, 1981; Hróbjartsson & Norup, 2003; Lange, 1981; Lim & Seet, 2007; Lynöe, Mattsson, & Sandlund, 1993; Nitzan & Lichtenberg, 2004; Saupe, 1986; Schwartz, Soumerai, & Avorn, 1989; Shapiro & Struening, 1973a, 1973b; Sherman & Hickner, 2008; Thomson & Buchanan, 1982; Tilburt, Emanuel, Kaptchuk, Curlin, & Miller, 2008). These reports prove that placebo interventions are indeed used in clinical practice; however, the data on the frequency of their use are highly variable.…”

“…These reports prove that placebo interventions are indeed used in clinical practice; however, the data on the frequency of their use are highly variable. In studies that were based on questionnaires (and also in those based on interviews), the usage of placebos was admitted by a proportion of physicians (from 17% to 99%; Bernateck et al, 2009; Classen & Feingold, 1985; Fässler et al, 2009; Goodwin et al, 1979; Gray & Flynn, 1981; Hróbjartsson & Norup, 2003; Lynöe et al, 1993; Nitzan & Lichtenberg, 2004; Sherman & Hickner, 2008; Tilburt et al, 2008) and nurses (from 51% to 100%; Bernateck et al, 2009; Ernst & Abbot, 1997; Goldberg et al, 1979; Goodwin et al, 1979; Gray & Flynn, 1981; Nitzan & Lichtenberg, 2004; Saupe, 1986). However, when the subjects were asked to record all the cases of placebo interventions that were given during a specified period of time, the rate of placebo interventions they reported ranged from only 0.3% to 5.1% (Goodwin et al, 1979; Lange, 1981).…”

Die Zulässigkeit von Placebos im klinischen Alltag

“…Offizinell gibt keine Bezugsquellen für Placebos, wo bekommt man sie eigentlich her? In der Praxis werden Pseudoplacebos bevorzugt, das sind Präparate, die definierte Inhaltsstoffe enthalten, für die es aber keinen Wirkungsnachweis gibt [14]. Das Placebo-Problem ist eine Art Refugium für diejenigen Bereiche der Heilkunde geworden, für die sich kein von den handelnden Individuen unabhängiges therapeutisches Agens oder Prinzip hat empirisch stabilisieren lassen.…”