Prescribing "placebo treatments": results of national survey of US internists and rheumatologists.
Prescribing "placebo treatments": results of national survey of US internists and rheumatologists.
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DOI：
10.1136/bmj.a1938
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发表时间：
2008-10-23
影响因子：
105.7
通讯作者：
Miller, Franklin G.
中科院分区：
文献类型：
--
作者：
Tilburt, Jon C.;Emanuel, Ezekiel J.;Kaptchuk, Ted J.;Curlin, Farr A.;Miller, Franklin G.
目的描述对安慰剂治疗的态度和行为，安慰剂治疗的定义是一种治疗的好处来自积极的患者的期望，而不是从治疗本身的生理机制。设计横断面邮寄调查。设置医生的临床实践。参与者1200执业内科医生和风湿病学家在美国。主要结果测量研究者测量了医生自我报告的关于使用安慰剂治疗的行为和态度，包括他们是否会使用或推荐“安慰剂治疗”，他们对实践的道德判断，他们推荐的安慰剂治疗，以及他们通常如何与患者沟通。结果679名医生（57%）回答了调查。大约一半的内科医生和风湿病学家报告定期开安慰剂治疗（46- 58%，取决于问题的措辞）。大多数医生（399，62%）认为这种做法在道德上是允许的。很少有人报告使用生理盐水（18，3%）或糖丸（12，2%）作为安慰剂治疗，而大部分人报告在过去一年中使用非处方镇痛药（267，41%）和维生素（243，38%）作为安慰剂治疗。在同一时期，一小部分但值得注意的医生报告使用抗生素（86，13%）和镇静剂（86，13%）作为安慰剂治疗。此外，使用安慰剂治疗的医生最常向患者描述其为潜在有益的药物或通常不用于其病情的治疗（241，68%）;他们很少明确将其描述为安慰剂（18，5%）。结论：在接受调查的美国内科医生和风湿病学家中，处方安慰剂治疗似乎很常见，并且被视为伦理上允许的。维生素和非处方止痛药是最常用的治疗方法。医生可能不会对患者完全透明地使用安慰剂，并且可能有混合的动机推荐这种治疗。
Objective To describe the attitudes and behaviours regarding placebo treatments, defined as a treatment whose benefits derive from positive patient expectations and not from the physiological mechanism of the treatment itself. Design Cross sectional mailed survey. Setting Physicians’ clinical practices. Participants 1200 practising internists and rheumatologists in the United States. Main outcome measures Investigators measured physicians’ self reported behaviours and attitudes concerning the use of placebo treatments, including measures of whether they would use or had recommended a “placebo treatment,” their ethical judgments about the practice, what they recommended as placebo treatments, and how they typically communicate with patients about the practice. Results 679 physicians (57%) responded to the survey. About half of the surveyed internists and rheumatologists reported prescribing placebo treatments on a regular basis (46-58%, depending on how the question was phrased). Most physicians (399, 62%) believed the practice to be ethically permissible. Few reported using saline (18, 3%) or sugar pills (12, 2%) as placebo treatments, while large proportions reported using over the counter analgesics (267, 41%) and vitamins (243, 38%) as placebo treatments within the past year. A small but notable proportion of physicians reported using antibiotics (86, 13%) and sedatives (86, 13%) as placebo treatments during the same period. Furthermore, physicians who use placebo treatments most commonly describe them to patients as a potentially beneficial medicine or treatment not typically used for their condition (241, 68%); only rarely do they explicitly describe them as placebos (18, 5%). Conclusions Prescribing placebo treatments seems to be common and is viewed as ethically permissible among the surveyed US internists and rheumatologists. Vitamins and over the counter analgesics are the most commonly used treatments. Physicians might not be fully transparent with their patients about the use of placebos and might have mixed motivations for recommending such treatments.
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影响因子：
105.7
作者：
Nitzan, U;Lichtenberg, P
通讯作者：
Lichtenberg, P
影响因子：
168.9
作者：
Kaptchuk, TJ
通讯作者：
Kaptchuk, TJ
影响因子：
39.2
作者：
BRODY, H
通讯作者：
BRODY, H
影响因子：
39.2
作者：
GOODWIN, JS;GOODWIN, JM;VOGEL, AV
通讯作者：
VOGEL, AV
影响因子：
7
作者：
GRAY, G;FLYNN, P
通讯作者：
FLYNN, P