Placebo use in the United kingdom: results from a national survey of primary care practitioners.
Placebo use in the United kingdom: results from a national survey of primary care practitioners.
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DOI：
10.1371/journal.pone.0058247
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Lewith G
中科院分区：
文献类型：
--
作者：
Howick J;Bishop FL;Heneghan C;Wolstenholme J;Stevens S;Hobbs FD;Lewith G
不同国家的调查显示，17%到80%的医生在日常实践中开“安慰剂”，但在英国初级保健中使用安慰剂的流行程度尚不清楚。我们对英国全科医生的代表性样本进行了一份基于网络的问卷调查。根据在其他国家进行的调查，我们将安慰剂分为“纯”和“不纯”。“不纯”安慰剂是指对某些疾病有明显疗效的干预措施，但用于疗效未知的疾病，例如用于疑似病毒感染的抗生素。“纯”安慰剂是一种干预措施，如糖丸或生理盐水注射，对治疗的疾病没有直接的药理活性成分。我们于2012年4月开始调查。发送两次提醒，4周后关闭电子数据收集。我们调查了1715名全科医生，其中783人（46%）完成了问卷调查。我们的受访者与所有注册的英国医生相似，这表明我们的结果是可推广的。12% （95% CI 10 - 15）的受访者使用纯安慰剂，97% （95% CI 96 - 98）的受访者在其职业生涯中至少使用过一次不纯安慰剂。1%的受访者使用纯安慰剂，77% （95% CI 74 - 79）每周至少使用一次不纯安慰剂。大多数受访者（66%认为是纯的，84%认为是不纯的）表示安慰剂在某些情况下是合乎道德的。安慰剂的使用在初级保健中很常见，但关于其益处、危害、成本以及是否符合伦理的问题仍然存在。需要进一步的研究来调查道德上可接受和具有成本效益的安慰剂干预措施。
Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown. We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. ‘Pure’ placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks. We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances. Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.
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DOI：
10.1001/jama.2012.115
发表时间：
2012-02-08
期刊：
JAMA
影响因子：
--
作者：
Colloca L;Finniss D
通讯作者：
Finniss D
影响因子：
105.7
作者：
Ernst, E
通讯作者：
Ernst, E
影响因子：
13.4
作者：
Foddy, Bennett
通讯作者：
Foddy, Bennett
影响因子：
2.8
作者：
Fässler M;Gnädinger M;Rosemann T;Biller-Andorno N
通讯作者：
Biller-Andorno N
影响因子：
5.9
作者：
Heneghan, Carl;Perera, Rafael;Glasziou, Paul
通讯作者：
Glasziou, Paul