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Placebo use in the UK: a qualitative study exploring GPs’ views on placebo effects in clinical practice

Placebo use in the UK: a qualitative study exploring GPs’ views on placebo effects in clinical practice
Placebo use in the UK: a qualitative study exploring GPs’ views on placebo effects in clinical practice
BACKGROUND:

Surveys show GPs use placebos in clinical practice and reported prevalence rates vary widely.
AIM:

To explore GPs' perspectives on clinical uses of placebos.
DESIGN AND SETTING:

A web-based survey of 783 UK GPs' use of placebos in clinical practice.
METHODS:

Qualitative descriptive analysis of written responses ('comments') to three open-ended questions.
RESULTS:

Comments were classified into three categories: (i) defining placebos and their effects in general practice; (ii) ethical, societal and regulatory issues faced by doctors and (iii) reasons why a doctor might use placebos and placebo effects in clinical practice. GPs typically defined placebos as lacking something, be that adverse or beneficial effects, known mechanism of action and/or scientific evidence. Some GPs defined placebos positively as having potential to benefit patients, primarily through psychological mechanisms. GPs described a broad array of possible harms and benefits of placebo prescribing, reflecting fundamental bioethical principles, at the level of the individual, the doctor-patient relationship, the National Health Service and society. While some GPs were adamant that there was no place for placebos in clinical practice, others focused on the clinically beneficial effects of placebos in primary care.
CONCLUSION:

This study has elucidated specific costs, benefits and ethical barriers to placebo use as perceived by a large sample of UK GPs. Stand-alone qualitative work would provide a more in-depth understanding of GPs' views. Continuing education and professional guidance could help GPs update and contextualize their understanding of placebos and their clinical effects.
0263-2136
357-363
Bishop, F.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Howick, J.
c6a90b32-af65-42b4-a004-714c96bfb615
Heneghan, C.
1556fc5b-1885-4875-9215-3464043c2f19
Stevens, S.
2e41ddd3-c0b4-42b8-9091-2d210a2fa085
Hobbs, R.
0b9003ed-1ba8-4638-8af2-890b9abcd6ba
Lewith, G.
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Bishop, F.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Howick, J.
c6a90b32-af65-42b4-a004-714c96bfb615
Heneghan, C.
1556fc5b-1885-4875-9215-3464043c2f19
Stevens, S.
2e41ddd3-c0b4-42b8-9091-2d210a2fa085
Hobbs, R.
0b9003ed-1ba8-4638-8af2-890b9abcd6ba
Lewith, G.
0fc483fa-f17b-47c5-94d9-5c15e65a7625

Bishop, F., Howick, J., Heneghan, C., Stevens, S., Hobbs, R. and Lewith, G. (2014) Placebo use in the UK: a qualitative study exploring GPs’ views on placebo effects in clinical practice. Family Practice, 31 (3), 357-363. (doi:10.1093/fampra/cmu016).

Record type: Article

Abstract

BACKGROUND:

Surveys show GPs use placebos in clinical practice and reported prevalence rates vary widely.
AIM:

To explore GPs' perspectives on clinical uses of placebos.
DESIGN AND SETTING:

A web-based survey of 783 UK GPs' use of placebos in clinical practice.
METHODS:

Qualitative descriptive analysis of written responses ('comments') to three open-ended questions.
RESULTS:

Comments were classified into three categories: (i) defining placebos and their effects in general practice; (ii) ethical, societal and regulatory issues faced by doctors and (iii) reasons why a doctor might use placebos and placebo effects in clinical practice. GPs typically defined placebos as lacking something, be that adverse or beneficial effects, known mechanism of action and/or scientific evidence. Some GPs defined placebos positively as having potential to benefit patients, primarily through psychological mechanisms. GPs described a broad array of possible harms and benefits of placebo prescribing, reflecting fundamental bioethical principles, at the level of the individual, the doctor-patient relationship, the National Health Service and society. While some GPs were adamant that there was no place for placebos in clinical practice, others focused on the clinically beneficial effects of placebos in primary care.
CONCLUSION:

This study has elucidated specific costs, benefits and ethical barriers to placebo use as perceived by a large sample of UK GPs. Stand-alone qualitative work would provide a more in-depth understanding of GPs' views. Continuing education and professional guidance could help GPs update and contextualize their understanding of placebos and their clinical effects.

Full text not available from this repository.

More information

Accepted/In Press date: 21 March 2014
e-pub ahead of print date: 15 April 2014
Published date: June 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 364165
URI: https://eprints.soton.ac.uk/id/eprint/364165
ISSN: 0263-2136
PURE UUID: aee400fe-fb2d-452b-b8c1-f6094ff78222
ORCID for F. Bishop: ORCID iD orcid.org/0000-0002-8737-6662

Catalogue record

Date deposited: 07 Apr 2014 16:08
Last modified: 05 Nov 2019 01:51

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