Nitzan Uriel, Lichtenberg Pesach
Herzog Hospital and Hadassah School of Medicine, Department of Psychiatry, POB 35300, Jerusalem 91351, Israel.
BMJ. 2004 Oct 23;329(7472):944-6. doi: 10.1136/bmj.38236.646678.55. Epub 2004 Sep 17.
To gauge the frequency and circumstances of use of placebo in clinical practice and the attitudes towards its use among those who administer it.
Retrospective questionnaire.
Two large hospitals and various community clinics in the Jerusalem area.
31 physicians working in hospital inpatient and outpatient departments, 31 head nurses working in hospital inpatient departments, and 27 family physicians working in community clinics.
Self report of frequency and circumstances of, and attitudes towards, use of placebo.
Among the 89 respondents, 53 (60%) used placebos (95% confidence interval 49% to 70%). Among users, 33 (62%) prescribed a placebo as often as once a month or more; 36 (68%) told patients they were receiving actual medication; 15 (28%) considered that placebos were a diagnostic tool; and 48/51 (94%) reported that they found placebos generally or occasionally effective.
Most practitioners questioned in this study continue to use placebos. Used wisely, placebos might have a legitimate place in therapeutics. Wider recognition of the practice and debate about its implications are imperative.
评估临床实践中安慰剂的使用频率及情况,以及给药者对其使用的态度。
回顾性问卷调查。
耶路撒冷地区的两家大型医院及多家社区诊所。
31名在医院住院部和门诊部工作的医生、31名在医院住院部工作的护士长以及27名在社区诊所工作的家庭医生。
关于安慰剂使用频率及情况以及对其使用态度的自我报告。
在89名受访者中,53人(60%)使用过安慰剂(95%置信区间为49%至70%)。在使用者中,33人(62%)每月或更频繁地开具安慰剂;36人(68%)告知患者他们正在接受实际药物治疗;15人(28%)认为安慰剂是一种诊断工具;48/51(94%)报告称他们发现安慰剂总体上或偶尔有效。
本研究中接受询问的大多数从业者继续使用安慰剂。若明智使用,安慰剂在治疗中可能有合理的地位。必须更广泛地认识这种做法并对其影响展开辩论。