Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Hepatology and Nutrition, Room C2-312, PO Box 22700, Amsterdam, 1100 DD, The Netherlands.
Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.
Eur J Pediatr. 2023 Mar;182(3):1425-1428. doi: 10.1007/s00431-022-04801-4. Epub 2023 Jan 6.
The placebo response a significant therapeutic improvement after a placebo intervention - can be high in children. The question arises of how optimal advantages of placebo treatment in pediatric clinical care be achieved. In this era of shared-decision making, it is important to be aware of patients' and parental attitudes. Therefore, the aim of the current study was to assess teenagers' and parental views on the use of placebo pills in pediatric clinical care. All patients (aged 12-18 years) and parents of children (aged 0-18 years), visiting the pediatric outpatient clinic between March 2020 through December 2020, were invited to participate in this study multicenter survey study. Of 1644 distributed questionnaires: 200/478 (47%) teenagers and 456/1166 (45%) parents filled out the complete survey. More parents were positive towards prescribing placebo medication than teenagers (80% vs. 71%, p = .019), especially when the clinician disclosed the use of a placebo to parents and teenagers, respectively (76% vs. 55%, p = .019). Increasing age of teenagers was positively associated with the willingness for placebo interventions (OR 0.803, 95%CI 0.659-0.979), as was a higher level of parental education (OR 0.706, 95%CI 0.526-0.949). Conclusion: This study emphasizes the willingness of teenagers and parents to receive placebo medication. Placebo medication becoming more acceptable and integrated into daily care may contribute to a decrease in medication use. What is Known: • A placebo is a treatment without inherent power to produce any therapeutic effect, but can result in significant therapeutic improvement, the so-called placebo response. • Treatment response rates after placebo interventions in children can be high, ranging from 41 to 46% in pediatric trials. What is New: • Most teenagers (71%) and parents (80%) find it appropriate for healthcare professionals to prescribe placebo medication. • Compared to adult care, pediatrics has a unique feature to disclose placebo treatment to parents while concealing it for the young patient: the majority of teenagers (85%) and parents (91%) agree to disclose placebo treatment to parents exclusively.
安慰剂效应——在接受安慰剂干预后出现显著治疗效果——在儿童中可能很高。问题是如何在儿科临床护理中实现最佳的安慰剂治疗优势。在这个共同决策的时代，了解患者和家长的态度非常重要。因此，本研究的目的是评估青少年和家长对在儿科临床护理中使用安慰剂的看法。所有（年龄在 12-18 岁）患者和儿童（年龄在 0-18 岁）的家长，于 2020 年 3 月至 2020 年 12 月期间在儿科门诊就诊，均被邀请参加这项多中心调查研究。在分发的 1644 份问卷中，有 200/478（47%）名青少年和 456/1166（45%）名家长填写了完整的调查问卷。与青少年相比，更多的家长对开安慰剂持积极态度（80%对 71%，p=0.019），特别是当医生分别向家长和青少年透露使用安慰剂时（76%对 55%，p=0.019）。青少年年龄越大，越愿意接受安慰剂干预（OR 0.803，95%CI 0.659-0.979），家长的教育水平越高，也越愿意接受安慰剂干预（OR 0.706，95%CI 0.526-0.949）。结论：本研究强调了青少年和家长接受安慰剂治疗的意愿。安慰剂治疗变得更加容易接受并融入日常护理中，可能有助于减少药物的使用。已知的：•安慰剂是一种没有内在治疗作用但可能产生显著治疗效果的治疗方法，即所谓的安慰剂效应。•在儿科试验中，接受安慰剂干预后的治疗反应率可能很高，范围在 41%至 46%之间。新的发现：•大多数青少年（71%）和家长（80%）认为医生开安慰剂是合适的。•与成人护理相比，儿科有一个独特的特点，即可以向家长透露安慰剂治疗，而对年轻患者则隐瞒：大多数青少年（85%）和家长（91%）同意仅向家长透露安慰剂治疗。
