Internists say they prescribe placebos on occasion

In the first study examining American physicians' use of placebos in clinical practice in the 21st Century, 45 percent of Chicago internists report they have used a placebo at some time during their clinical practice researchers report in the January issue of Journal of General Internal Medicine.

This study indicates a need for greater recognition of the use of placebos and unproven therapies and discussion about its implications," say the study authors, Rachel Sherman, a fourth year medical student at the University of Chicago's Pritzker School of Medicine, and John Hickner, MD, MSc, professor of family medicine, at the University of Chicago and University of Chicago Medical Center.

The authors sent questionnaires inquiring about placebo use to 466 internists at the University of Chicago, Northwestern University, and University of Illinois – Chicago. Fifty percent (231) of the physicians responded.

"Placebos have been used in medicine since ancient times, and remain both clinically relevant and philosophically interesting. In addition to their recognized use as controls in clinical trials, this study suggests that placebos themselves are viewed as therapeutic tools in medical practice," says Sherman.

Of the respondents who reported using placebos in clinical practice, 34 percent introduced the placebos to the patient as "a substance that may help and will not hurt." Nineteen percent said, "it is medication," and nine percent said, "it is medicine with no specific effect." Only four percent of the physicians explicitly said, "it is a placebo." In addition, 33 percent of the physicians reported they gave other information to patients, including, "this may help you but I am not sure how it works."

Only 12 percent of respondents said that placebo use should be categorically prohibited. The authors write that in the broader ethics literature, the routine use of placebos is controversial. Some commentators on informed consent and non-deceptive therapeutics caution against the use of placebos in medical practice. Others propose that the placebo effect can be harnessed in various therapeutic contexts that do not pose ethical dilemmas.

In addition, the authors say a growing number of physicians believe in mind-body connection; which means what a person thinks can impact the health and well-being of the body. Rather than using placebos to differentiate between patients who were faking their symptoms and those with genuine symptoms, as the majority of physicians did according to research several decades ago, 96 percent of physicians in this study believed placebos can have therapeutic benefits for patients.

The physicians most commonly defined a placebo as an intervention not expected to have an effect through a known or specific physiologic mechanism. Researchers then asked physicians about the possible benefits of other treatment and factors that may influence health according to this definition of a placebo.

Physicians responded to questions about whether there might be psychological or physiological benefits to meditation, yoga, or relaxation techniques; biofeedback; prayer or spirituality; a good social support system; having good doctor-patient rapport, and interior design of the healthcare environment. In most cases, the majority of physicians believed in both psychological and physiological benefits.

Source: University of Chicago Medical Center

Related stories:

Costly placebo works better than cheap one
A 10-cent pill doesn't kill pain as well as a $2.50 pill, even when they are identical placebos, according to a provocative study by Dan Ariely, a behavioral economist at Duke University.
Porous structures help boost integration of host tissue with implants, study finds
Results published today in FASEB (the journal of the Federation of American Societies for Experimental Biology) by researchers at Columbia University, including Jeremy Mao of the Columbia College of Dental Medicine, demonstrate a novel way of using porous structures as a drug-delivery vehicle that can help boost the integration of host tissue with surgically implanted titanium.
NSAIDs are effective for short-term relief of low-back pain
Non steroidal anti-inflammatory drugs (NSAIDs; such as aspirin and ibuprofen) can help reduce symptoms of low back pain that doesn’t involve sciatica, a Cochrane Systematic Review has found.
Less than one-third of women aware of landmark hormone therapy study, researcher finds
Despite the huge publicity generated by a 2002 study on the potential dangers of hormone therapy for postmenopausal women, new research from the Stanford University School of Medicine found that only 29 percent of women surveyed knew about the study two years later.
Genetic variation impacts aspirin's effectiveness in preventing colon cancer
Dartmouth researchers are among a team of doctors that have learned more about how people may or may not benefit from taking aspirin in the effort to curb colon cancer. Their study, which appears in the Oct. 18 issue of the Journal of the National Cancer Institute, finds that the beneficial effect of aspirin may be limited to individuals who have a specific genetic variation in their ODC gene.
Researching the power of the placebo effect in arthritis patients
(PhysOrg.com) -- People with arthritis are to take part in new research carried out at The University of Manchester to find out more about how the placebo effect works.
Viagra helps depressed women: study
The erectile dysfunction drug Viagra has proven effective at combating sexual dysfunction in depressed women, according to a study published Tuesday.
Smoking cessation therapies more effective than placebos
Six treatments for smoking cessation perform better than placebos — including varenicline (Chantix®), recently approved for use in Canada — states a team of researchers from McGill University and the University of Montreal in an article published in CMAJ.

News discussion:

Medicine & Health news