Attitudes to and Understanding of Placebo Use: A Cross- Sectional Exploratory Study in a Malaysian Hospital
Background: This study explored doctors’ understanding of ‘placebo’, mechanisms of action, perceptions about effectiveness and concerns about use in a Malaysian teaching hospital. Methods: A survey questionnaire. Results: Respondents were 76 doctors (response rate: 55%): 52% were female, mean age was 32 years, and 61% were physicians/medical officers. Most (66.2%) never used a placebo. The main reason for use of placebos was for a possible psychological effect. Placebo use was considered unacceptable due to endangering of doctor-patient trust (59.2%) or patient deception (47.4%). Conclusion: Developing specific and professional standards and guidance on placebo use could help doctors to leverage the benefits of placebo use without endangering the doctor-patient relationship.
2. Babel P. Use of placebo interventions in primary care in Poland. Med Princ Pract. 2013;22(5):484-8.
3. Sherman R, Hickner J. Academic physicians use placebos in clinical practice and believe in the mind–body connection. J Gen Intern Med. 2008 Jan;23(1):7- 10.
4. Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ. 2008 May 3;336(7651):999-1003.
5. Haour F. Mechanisms of the placebo effect and of conditioning. Neuroim¬munomodulation. 2005;12(4):195-200.
6. Meissner K, Distel H, Mitzdorf U. Evidence for placebo effects on physical but not on biochemical outcome parameters: a review of clinical trials. BMC Med. 2007 Mar 19;5:3.
7. Zubieta JK, Bueller JA, Jackson LR, Scott DJ, Xu Y, Koeppe RA, et al. Placebo
effects mediated by endogenous opioid activity on mu-opioid receptors. J Neurosci. 2005 Aug 24;25(34):7754-62.
8. Enck P, Benedetti F, Schedlowski M. New insights into the placebo and nocebo responses. Neuron. 2008 Jul 31;59(2):195-206.
9. Biller N. The placebo effect: mocking or mirroring medicine? Perspect Biol Med. 1999 Spring;42(3):398-401.
10. Biller-Andorno N. The use of the placebo effect in clinical medicine—ethi¬cal blunder or ethical imperative? Sci Eng Ethics. 2004 Jan;10(1):43-50.
11. Bishop FL, Aizlewood L, Adams AE. When and why placebo-prescribing is acceptable and unacceptable: a focus group study of patients' views. PLoS One. 2014 Jul 9;9(7):e101822.
12. Kluge EH. Placebos: some ethical considerations. CMAJ. 1990 Feb 15;142(4):293-5.
13. Simmons B. Problems in deceptive medical procedures: an ethical and legal analysis of the administration of placebos. J Med Ethics. 1978 Dec;4(4):172-81.
14. Thomas KB. The placebo in general practice. Lancet. 1994 Oct 15;344(8929):1066-7.
15. Meissner K, Höfner L, Fässler M, Linde K. Widespread use of pure and im¬pure placebo interventions by GPs in Germany. Fam Pract. 2012 Feb;29(1):79- 85.
16. Fässler M, Gnädinger M, Rosemann T, Biller-Andorno N. Use of placebo
interventions among Swiss primary care providers. BMC Health Serv Res. 2009 Aug 10;9:144.
17. Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, Miller FG. Prescribing “pla¬cebo treatments”: results of national survey of US internists and rheumato¬logists. BMJ. 2008 Oct 23;337:a1938.
18. Kienle GS, Kiene H. The powerful placebo effect: fact or fiction? J Clin Epidemiol. 1997 Dec;50(12):1311-8.
19. Fässler M, Meissner K, Kleijnen J, Hróbjartsson A, Linde K. A systematic review found no consistent difference in effect between more and less inten¬sive placebo interventions. J Clin Epidemiol. 2015 Apr;68(4):442-51.
20. Harris CS, Campbell NK, Raz A. Placebo trends across the border: US versus Canada. Plos One. 2015 Nov 25;10(11):e0142804.
21. Miller FG, Rosenstein DL. The nature and power of the placebo effect. J Clin Epidemiol. 2006 Apr;59(4):331-5.
22. Benedetti F, Carlino E, Pollo A. Hidden administration of drugs. Clin Phar¬macol Ther. 2011 Nov;90(5):651-61.
23. Linde K, Witt CM, Streng A, Weidenhammer W, Wagenpfeil S, Brinkhaus B, et al. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain. 2007 Apr;128(3):264-71.
24. de Craen AJ, Kaptchuk TJ, Tijssen JG, Kleijnen J. Placebos and placebo effects in medicine: historical overview. J R Soc Med. 1999 Oct;92(10):511-5.
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