Widespread use of pure and impure placebo interventions by GPs in Germany
Widespread use of pure and impure placebo interventions by GPs in Germany
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DOI：
10.1093/fampra/cmr045
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发表时间：
2012-02-01
期刊：
影响因子：
2.2
通讯作者：
Linde, Klaus
中科院分区：
文献类型：
--
作者：
Meissner, Karin;Hoefner, Lisa;Linde, Klaus
的目标。收集德国全科医生使用安慰剂干预的数据。一份调查问卷邮寄给巴伐利亚州随机选择的400名全科医生。4周后通过电话提醒无应答者，3周后再发一份问卷。总共收回了208份完整的问卷。大多数全科医生（88%）在实践中至少使用过一次安慰剂；45%的人去年至少使用过一次纯安慰剂，比如生理盐水注射和糖丸；使用频率中位数为5[四分位间距（IQR）， 2-10]。在过去一年中，使用不纯安慰剂的情况更为普遍：76%的全科医生使用不纯安慰剂，即具有药理或物理作用但对患者疾病或其症状没有内在影响（例如药理或物理作用）的医疗干预措施，平均频率为每年20次（IQR, 10-50）。使用安慰剂的主要原因是一种可能的心理效应，其次是患者接受治疗的期望。对于大多数全科医生来说，如果安慰剂干预是为了可能的心理效果而使用，那么在伦理上是合理的。安慰剂干预是德国一般做法中被广泛接受的医学治疗的一部分，主要用于其心理效果。不纯安慰剂的使用频率比纯安慰剂高得多。
Aim. To collect data on the use of placebo interventions by GPs in Germany.Methods. A questionnaire was mailed to 400 randomly selected GPs in Bavaria. Non-responders were reminded by telephone after 4 weeks and were given a second copy of the questionnaire after a further 3 weeks.Results. In all, 208 completed questionnaires were returned. The majority of GPs (88%) have used a placebo at least once in their practice; 45% have used pure placebos, such as saline injections and sugar pills, at least once last year; the median frequency of use was 5 [interquartile range (IQR), 2-10]. The use of impure placebos during the past year was more common: 76% of GPs have used impure placebos, i.e. medical interventions that have pharmacological or physical activity but have no intrinsic effect (e. g. pharmacological or physical action) on the patient's disease or its symptoms, with a median frequency of 20 times per year (IQR, 10-50). The main reason for the use of placebo was a possible psychological effect, followed by the expectation of patients to receive a treatment. For the majority of GPs placebo interventions were ethically justified if they were used for a possible psychological effect.Conclusions. Placebo interventions are a widely accepted part of medical treatment in German general practices and are used primarily for their psychological effects. Impure placebos are used much more frequently than pure placebos.