Use of placebo interventions among Swiss primary care providers.
Use of placebo interventions among Swiss primary care providers.
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DOI：
10.1186/1472-6963-9-144
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发表时间：
2009-08-10
影响因子：
2.8
通讯作者：
Biller-Andorno N
中科院分区：
文献类型：
--
作者：
Fässler M;Gnädinger M;Rosemann T;Biller-Andorno N
安慰剂干预可能对患者产生有意义的影响。然而，很少有人知道他们在临床实践中使用的情况。我们的目的是调查瑞士初级保健提供者使用安慰剂干预的程度和方式。此外，我们还探讨了他们对所涉及的伦理和法律的问题的看法。在瑞士苏黎世州的私人执业的全科医生（GP）和儿科医生发送了599份问卷。为了进行亚组分析，以平均比例选择城市、郊区和农村地区的全科医生以及儿科医生。共完成问卷233份（回复率47%）。28%的参与者报告说他们从未使用过安慰剂干预措施。更多的参与者在治疗上使用不纯的安慰剂而不是纯安慰剂（57%对17%，McNemar的χ2 = 78，p < 0.001）。安慰剂处方没有明确的主要原因。安慰剂的使用大多以“药物或治疗”的形式传达给患者（64%）。最常选择的伦理前提是“只要医生和患者合作，就可以使用”（纯安慰剂为60%，不纯安慰剂为75%，McNemar χ2 = 12，p < 0.001）。相当多的参与者（11-38%）对使用安慰剂的伦理和法律的合法性的陈述犹豫不决。从瑞士初级保健提供者获得的数据反映了对安慰剂干预的各种各样的看法，以及对其合法性的普遍不确定性。初级保健提供者在日常实践中似乎优先使用不纯安慰剂而不是纯安慰剂。关于医疗专业人员临床使用安慰剂干预措施的适当标准，需要进行激烈的辩论。
Placebo interventions can have meaningful effects for patients. However, little is known about the circumstances of their use in clinical practice. We aimed to investigate to what extent and in which way Swiss primary care providers use placebo interventions. Furthermore we explored their ideas about the ethical and legal issues involved. 599 questionnaires were sent to general practitioners (GPs) and paediatricians in private practice in the Canton of Zurich in Switzerland. To allow for subgroup analysis GPs in urban, suburban, and rural areas as well as paediatricians were selected in an even ratio. 233 questionnaires were completed (response rate 47%). 28% of participants reported that they never used placebo interventions. More participants used impure placebos therapeutically than pure placebos (57% versus 17%, McNemar's χ2 = 78, p < 0.001). There is not one clear main reason for placebo prescription. Placebo use was communicated to patients mostly as being "a drug or a therapy" (64%). The most frequently chosen ethical premise was that they "can be used as long as the physician and the patient work together in partnership" (60% for pure and 75% for impure placebos, McNemar's χ2 = 12, p < 0.001). A considerable number of participants (11–38%) were indecisive about statements regarding the ethical and legal legitimacy of using placebos. The data obtained from Swiss primary care providers reflect a broad variety of views about placebo interventions as well as a widespread uncertainty regarding their legitimacy. Primary care providers seem to preferentially use impure as compared to pure placebos in their daily practice. An intense debate is required on appropriate standards regarding the clinical use of placebo interventions among medical professionals.
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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：
105.7
作者：
Tilburt, Jon C.;Emanuel, Ezekiel J.;Kaptchuk, Ted J.;Curlin, Farr A.;Miller, Franklin G.
通讯作者：
Miller, Franklin G.
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：
5.4
作者：
LYNOE, N;MATTSSON, B;SANDLUND, M
通讯作者：
SANDLUND, M