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  3. Patients’ attitudes about the use of placebo treatments: telephone survey
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Research

Patients’ attitudes about the use of placebo treatments: telephone survey

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f3757 (Published 02 July 2013) Cite this as: BMJ 2013;347:f3757
  1. Sara Chandros Hull, bioethicist12,
  2. Luana Colloca, research fellow234,
  3. Andrew Avins, research scientist5,
  4. Nancy P Gordon, research scientist5,
  5. Carol P Somkin, research scientist5,
  6. Ted J Kaptchuk, director6,
  7. Franklin G Miller, bioethicist23
  1. 1Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
  2. 2Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD, USA
  3. 3National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
  4. 4National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, MD, USA
  5. 5Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
  6. 6Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
  1. Correspondence to: S C Hull shull{at}mail.nih.gov

Abstract

Objective To examine the attitudes of US patients about the use of placebo treatments in medical care.

Design One time telephone surveys.

Setting Northern California.

Participants 853 members of Kaiser Permanente Northern California, aged 18-75, who had been seen by a primary care provider for a chronic health problem at least once in the prior six months.

Results The response rate was 53.4% (853/1598) of all members who were eligible to participate, and 73.2% (853/1165) of all who could be reached by telephone. Most respondents (50-84%) judged it acceptable for doctors to recommend placebo treatments under conditions that varied according to doctors’ level of certainty about the benefits and safety of the treatment, the purpose of the treatment, and the transparency with which the treatment was described to patients. Only 21.9% of respondents judged that it was never acceptable for doctors to recommend placebo treatments. Respondents valued honesty by physicians regarding the use of placebos and believed that non-transparent use could undermine the relationship between patients and physicians.

Conclusions Most patients in this survey seemed favorable to the idea of placebo treatments and valued honesty and transparency in this context, suggesting that physicians should consider engaging with patients to discuss their values and attitudes about the appropriateness of using treatments aimed at promoting placebo responses in the context of clinical decision making.

Footnotes

  • We thank Christine Grady and Justin Lowenthal for their helpful review of emerging drafts of this manuscript.

  • Contributors: SCH designed the survey instrument, monitored data collection for the survey, analyzed data, and drafted and revised the paper. She is guarantor. LC designed the survey instrument, analyzed data, and revised the paper. AA, NPG, and CPS designed the survey instrument, implemented the survey within Kaiser Permanente Northern California, monitored data collection for the survey, developed the statistical analysis plan, cleaned and analysed the data, and revised the paper. TPK designed the survey instrument and revised the paper. FGM initiated the collaborative project, designed the survey instrument, monitored data collection for the survey, analyzed data, and revised the paper. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding: This research was supported by the National Center for Complementary and Alternative Medicine, the Clinical Center, and the intramural research program of the National Human Genome Research Institute, National Institutes of Health. The opinions expressed are those of the authors and do not necessarily reflect the policies or views of the National Institutes of Health or the Department of Health and Human Services. The study funders played no role in the study design; collection, analysis, and interpretation of data; writing of the report; or the decision to submit the article for publication. Researchers were independent of influence from study funders.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, and no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: All procedures were approved by the Kaiser Foundation Research Institute institutional review board, CN-10AAvin-02-H; and classified as exempt from review by the institutional review board at the National Institutes of Health.

  • Data sharing: No additional data available.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/.

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