Perception and practice of placebo use among physicians in Mangalore

Abstract

Background: Placebo use falls under two contexts: clinical care and research. In today's pharmacological era where treatment is available for almost all illnesses, there exists a lot of questions about the perceived efficacy and usage of placebos. This study focuses on assessing the knowledge, attitude, and practice of placebo use in clinical medicine. This study also aimed to pay attention to the ethical dimensions of using a placebo in clinical practice. Subjects and Methods: A cross-sectional study was conducted among 86 physicians in five hospitals and various private clinics in Mangalore, India, using a self-administered questionnaire. Results: About 72% of physicians were found to be prescribing placebos. Vitamins were the most commonly prescribed placebos. Pure placebos were prescribed by 69.4% and impure placebos by 83.9% of physicians. Pure placebos were deemed acceptable by 70.9% of physicians if used for their psychological effect, but only 46.5% said the same for impure placebos. Placebos were most commonly prescribed to conform to the patients' requests for some sort of medicine. Among our physicians, 54.8% and 62.8% of placebo prescribers felt that many or some patients would be disappointed if they were to find out that they had been treated with pure or impure placebos, respectively. Conclusion: Physicians agreed that placebos were acceptable in some circumstances in clinical practice. Physicians think that the information and training about placebos during their medical studies was insufficient. Perhaps, more time should be put into teaching about placebos during medical studies and proper guidelines should be laid down about placebo usage.

Keywords

• clinical pharmacology
• ethics
• general medicine
• general practice
• placebo use