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Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians

Bernstein, Michael H. and Locher, Cosima and Stewart-Ferrer, Sif and Buergler, Sarah and DesRoches, Catherine M. and Dossett, Michelle L. and Miller, Franklin G. and Grose, Deborah and Blease, Charlotte R.. (2020) Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians. British Journal of Health Psychology, 25 (3). pp. 596-614.

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Official URL: https://edoc.unibas.ch/80223/

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Abstract

To examine how primary care physicians define placebo concepts, use placebos in clinical practice, and view open-label placebos (OLPs).; Semi-structured focus groups that were audio-recorded and content-coded.; Two focus groups with a total of 15 primary care physicians occurred at medical centres in the New England region of the United States. Prior experience using placebo treatments and attitudes towards open-label placebos were explored. Themes were analysed using an inductive data-driven approach.; Physicians displayed a nuanced understanding of placebos and placebo effects in clinical contexts which sometimes focused on relational factors. Some respondents reported that they prescribed treatments with no known pharmacological effect for certain conditions and symptoms ('impure placebos') and that such prescriptions were more common for pain disorders, functional disorders, and medically unexplained symptoms. Opinions about OLP were mixed: Some viewed OLPs favourably or considered them 'harmless'; however, others strongly rejected OLPs as disrespectful to patients. Other issues in relation to OLPs included the following: lack of guidelines, legal and reputational concerns, and the notion that such treatments would run counter to customary medical practice.; A number of physicians reported prescribing impure placebos in clinical care. Although some primary care physicians were resistant to the possibility of recommending OLPs, others regarded OLPs more favourably, viewing them as potential treatments, albeit with restricted potential. Statement of contribution What is already known? Many physicians report prescribing drugs for the purposes of eliciting a placebo effect. Initial evidence for the efficacy of open-label placebos is promising. What does this study add? A more nuanced description of the circumstances under which primary care physicians report placebo prescribing. A qualitative account of physician attitudes about using open-label placebos in clinical practice.
Faculties and Departments:07 Faculty of Psychology > Departement Psychologie > Forschungsbereich Klinische Psychologie und Neurowissenschaften > Klinische Psychologie und Psychotherapie (Gaab)
UniBasel Contributors:Locher, Cosima
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:The British Psychological Society
e-ISSN:2044-8287
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:13 Oct 2021 15:51
Deposited On:13 Oct 2021 15:51

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