Attitudes to and Understanding of Placebo Use: A Cross- Sectional Exploratory Study in a Malaysian Hospital

Authors

  • Amanda Villiers Tuthill Perdana University Royal College of Surgeons in Ireland School of Medicine, Perdana University, Serdang, Malaysia.
  • Tay Zhuo Han Perdana University Royal College of Surgeons in Ireland School of Medicine, Perdana University, Serdang, Malaysia.
  • Chang Xian Chai International Medical University, Kuala Lumpur, Malaysia.
  • Ai Wen Chai Perdana University Royal College of Surgeons in Ireland School of Medicine, Perdana University, Serdang, Malaysia.
  • Chun Yiing Wong Sarawak General Hospital, Kuching, Sarawak, Malaysia.
  • Karen Morgan Royal College of Surgeons in Ireland, Dublin, Ireland.

DOI:

https://doi.org/10.5195/ijms.2016.162

Keywords:

Health knowledge; attitudes; and practice, Malaysia, Placebos, Placebo effect, Physician-patient relations

Abstract

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.

Metrics

Metrics Loading ...

Author Biography

Amanda Villiers Tuthill, Perdana University Royal College of Surgeons in Ireland School of Medicine, Perdana University, Serdang, Malaysia.

Tay Zhuo Han is currently a 4th year medical student at the Perdana University Royal College of Surgeons in Ireland School of Medicine, Perdana University, Kuala Lumpur, Malaysia

References

1. Howick J, Bishop FL, Heneghan C, Wolstenholme J, Stevens S, Hobbs FD, et al. Placebo use in the United Kingdom: results from a national survey of primary care practitioners. PLoS One. 2013;8(3):e58247.
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.

Downloads

Published

2016-12-31

How to Cite

Tuthill, A. V., Han, T. Z., Chai, C. X., Chai, A. W., Wong, C. Y., & Morgan, K. (2016). Attitudes to and Understanding of Placebo Use: A Cross- Sectional Exploratory Study in a Malaysian Hospital. International Journal of Medical Students, 4(3), 108–111. https://doi.org/10.5195/ijms.2016.162

Issue

Vol. 4 No. 3 (2016)

Section

Short Communication

Categories

License

  1. The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
  2. Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
  3. The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
    1. Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
    2. The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
    3. Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
    4. Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
    5. The Author represents and warrants that:
      1. the Work is the Author’s original work;
      2. the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
      3. the Work is not pending review or under consideration by another publisher;
      4. the Work has not previously been published;
      5. the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
      6. the Work contains no libel, invasion of privacy, or other unlawful matter.
    6. The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.

Enforcement of copyright

The IJMS takes the protection of copyright very seriously.

If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.

If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to contact@ijms.org

 

Infringing material

If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to contact@ijms.org