Placebo Prescriptions among General Practitioners in 21 Countries: the PURE Questionnaire
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This article is not in any list yet, why not save it to one of your lists.Abstract
Objectives. General practitioners (GPs) sometimes initiate a treatment despite not expecting it will improve patients’ symptoms by any known physiological mechanism. The frequency, risks, and ethics of these essentially placebo treatments are a topic of discussion. We aimed to estimate the frequency of prescribing essentially placebo treatments across and within multiple countries and to determine whether they are related to GPs' background characteristics.Design. Observational questionnaire study. Setting. An online questionnaire distributed to GPs in 21 countries. Participants. 952 practicing GPs (61% female, mean age 48 years) responded, with 669 answering all questions. Respondents were contacted by one national representative per country. Main outcome measures. The main outcome is the median prescription rate of essentially placebo treatments, overall and per country. Secondary outcomes were the prescription rate per consultation in relation to GP’s gender, age, education about placebos, years of experience, patients seen and working hours per week. Results. Across countries, 84% of respondents indicated they had prescribed an essentially placebo treatment at least once in their career. Overall, the median rate of essentially placebo prescriptions was once per 2 weeks or 0.7% of all consultations. The rate varied per country, from 0.1% of consultations in the UK to 2.5% of consultations in France. Across countries, the prescription rate was higher in male GPs (β = 0.11, p = 0.005), those with more work experience (β = 0.14, p < 0.001), and those who work fewer hours per week (β = -0.14, p = 0.001).Conclusions. Our results show that while placebo prescriptions feature in a small minority of consultations, they nevertheless occur regularly for most GPs, with small differences by country and GP background characteristics. Future research should further investigate the precise decision-making process behind these prescriptions and their effects on patients.