Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians.
open label placebo
placebo
placebo effect
primary care
Journal
British journal of health psychology
ISSN: 2044-8287
Titre abrégé: Br J Health Psychol
Pays: England
ID NLM: 9605409
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
20
03
2020
revised:
24
04
2020
pubmed:
31
5
2020
medline:
15
12
2020
entrez:
31
5
2020
Statut:
ppublish
Résumé
To examine how primary care physicians define placebo concepts, use placebos in clinical practice, and view open-label placebos (OLPs). Semi-structured focus groups that were audio-recorded and content-coded. Two focus groups with a total of 15 primary care physicians occurred at medical centres in the New England region of the United States. Prior experience using placebo treatments and attitudes towards open-label placebos were explored. Themes were analysed using an inductive data-driven approach. Physicians displayed a nuanced understanding of placebos and placebo effects in clinical contexts which sometimes focused on relational factors. Some respondents reported that they prescribed treatments with no known pharmacological effect for certain conditions and symptoms ('impure placebos') and that such prescriptions were more common for pain disorders, functional disorders, and medically unexplained symptoms. Opinions about OLP were mixed: Some viewed OLPs favourably or considered them 'harmless'; however, others strongly rejected OLPs as disrespectful to patients. Other issues in relation to OLPs included the following: lack of guidelines, legal and reputational concerns, and the notion that such treatments would run counter to customary medical practice. A number of physicians reported prescribing impure placebos in clinical care. Although some primary care physicians were resistant to the possibility of recommending OLPs, others regarded OLPs more favourably, viewing them as potential treatments, albeit with restricted potential. Statement of contribution What is already known? Many physicians report prescribing drugs for the purposes of eliciting a placebo effect. Initial evidence for the efficacy of open-label placebos is promising. What does this study add? A more nuanced description of the circumstances under which primary care physicians report placebo prescribing. A qualitative account of physician attitudes about using open-label placebos in clinical practice.
Identifiants
pubmed: 32472982
doi: 10.1111/bjhp.12429
pmc: PMC7423714
mid: NIHMS1603670
doi:
Substances chimiques
Placebos
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
596-614Subventions
Organisme : NCCIH NIH HHS
ID : K23 AT009218
Pays : United States
Organisme : Swiss National Science Foundation
ID : P400PS_180730
Pays : Switzerland
Organisme : Irish Research Council
Pays : International
Organisme : NIDA NIH HHS
ID : K01 DA048087
Pays : United States
Organisme : Foundation for the Science of the Therapeutic Encounter
Pays : International
Informations de copyright
© 2020 The British Psychological Society.
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