Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
BMJ. 2013 Jul 2;347:f3757. doi: 10.1136/bmj.f3757.
To examine the attitudes of US patients about the use of placebo treatments in medical care.
One time telephone surveys.
Northern California.
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.
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.
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.
调查美国患者对在医疗保健中使用安慰剂治疗的态度。
一次性电话调查。
加利福尼亚州北部。
在过去六个月中至少因慢性健康问题接受过一次初级保健提供者治疗的 Kaiser Permanente Northern California 的 853 名 18-75 岁的成员。
符合条件的所有成员中,有 53.4%(853/1598)的人回应了调查,所有可通过电话联系到的人中,有 73.2%(853/1165)的人回应了调查。大多数受访者(50-84%)认为,在医生对治疗的益处和安全性、治疗目的以及向患者描述治疗方法的透明度有一定把握的情况下,医生推荐安慰剂治疗是可以接受的。只有 21.9%的受访者认为,医生推荐安慰剂治疗永远是不可接受的。受访者重视医生在使用安慰剂方面的诚实,并认为不透明的使用可能会破坏医患关系。
这项调查中的大多数患者似乎对安慰剂治疗的想法持赞成态度,并重视这种情况下的诚实和透明度,这表明医生应该考虑与患者接触,讨论他们在临床决策中使用旨在促进安慰剂反应的治疗方法的适当性的价值观和态度。