Institute of Biomedical Ethics, University of Zurich, Zurich, Switzerland.
Br J Gen Pract. 2011 Feb;61(583):101-7. doi: 10.3399/bjgp11X556209.
Few studies have investigated whether patients and physicians differ in their attitudes regarding placebo interventions in medical practice.
To compare the proportions of patients and physicians who would accept therapies that do not work through specific pharmacological or physiological action but by enhancing self-healing capacities and by exploiting contextual factors.
Survey of a random sample of GPs and patients consecutively attending in primary care practices.
Four hundred and seventy-seven patients and 300 GPs from primary care practices of the Canton Zurich of Switzerland were approached.
Two questionnaires on responders' attitudes regarding non-specific therapies.
The response rates were 87% for patients and 79% for GPs. Eighty-seven per cent of patients and 97% of GPs thought that physical complaints can get better by believing in the effectiveness of the therapy. Overall there was more support for placebo interventions among patients than among GPs, yet 90% of the physicians admitted to actively proposing treatments intended to take advantage of non-specific effects. Seventy per cent of the patients wanted to be explicitly informed when receiving a non-specific intervention, whereas physicians thought this was the case for only 33% of their patients. Fifty-four per cent of patients would be disappointed when learning they had unknowingly been treated with pure placebo ('sugar pill'), while only 44% would feel that way after treatment with impure placebo (for example, herbal medicine).
GPs rather underestimate the openness of their patients to non-specific therapies. However, patients want to be appropriately informed. Developing specific professional standards could help physicians to harness the 'power of the placebo', while remaining authentic and credible.
很少有研究调查患者和医生在医学实践中对安慰剂干预的态度是否存在差异。
比较患者和医生接受非特异性治疗的比例，这些治疗不是通过特定的药理或生理作用，而是通过增强自我康复能力和利用环境因素来起作用。
对瑞士苏黎世州初级保健诊所的普通医生和患者进行随机抽样调查。
瑞士苏黎世州初级保健诊所的 477 名患者和 300 名普通医生参与了此次研究。
使用两份关于非特异性治疗态度的调查问卷对患者和医生进行调查。
患者的应答率为 87%，医生的应答率为 79%。87%的患者和 97%的医生认为，相信治疗的有效性可以使身体不适得到改善。总体而言，患者对安慰剂干预的支持率高于医生，但 90%的医生承认会积极提出旨在利用非特异性效应的治疗方法。70%的患者希望在接受非特异性干预时能得到明确的告知，而医生认为只有 33%的患者会有这种要求。54%的患者在得知自己不知情地接受了纯安慰剂（“糖丸”）治疗时会感到失望，而只有 44%的患者在接受不纯安慰剂（如草药）治疗后会有这种感觉。
普通医生低估了患者对非特异性治疗的开放性。然而，患者希望得到适当的告知。制定特定的专业标准可以帮助医生利用“安慰剂的力量”，同时保持真实和可信。
