06/16/2009 - News

Placebo Prescriptions May Be More Common Than You Think

By: June Chen, MD

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Placebo treatments are treatments whose benefits derive from positive patient expectations, rather than from the physiological mechanism of the treatment itself.

According to a national survey, many internists and rheumatologists in the United States regularly prescribe placebo treatments, including active drugs such as antibiotics and sedatives, often without explicitly informing their patients. The results of this survey were published online last week in BMJ.

679 physicians responded to a survey designed to measure their behaviors and attitudes concerning the use of placebo treatments, including whether they had recommended placebo treatments, their ethical judgments about the practice, what they recommended as placebos, and how they typically communicated with patients about placebo treatments. Approximately half of the respondents indicated they prescribed placebo treatments on a regular basis, and 62% of the doctors surveyed believed the practice to be ethically permissible. Of those who had prescribed placebo treatments, very few reported using the sugar pills which are typically associated with placebo treatments. 41% reported using over-the-counter pain medications and 38% reported using vitamins. However, more than 20% of the respondents reported using either antibiotics or sedatives as placebo treatments.

In this survey, 68% of the physicians reported that they had described placebo treatments to their patients as a potentially beneficial medicine or a treatment that was not typically used for their condition. Only approximately 5% of the doctors had explicitly described the treatment as a placebo.

The use of placebo treatments is controversial. Some criticize the use of placebos by claiming that placebo treatment is inherently deceptive. Others argue that placebo treatments are effective for many chronic conditions. The researchers who designed the survey suggested that prescribing over-the-counter medications and vitamins without full disclosure might not raise alarm bells, but prescribing antibiotics and sedatives without a clear medical indication could have serious consequences for both patients and public health in general.

Source
BMJ 2008;338:a1938.

Created on: 10/28/2008
Reviewed on: 06/16/2009

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