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The attitudes of patients and physicians towards placebo treatment--a comparative study.

https://arctichealth.org/en/permalink/ahliterature73377
Source
Soc Sci Med. 1993 Mar;36(6):767-74
Publication Type
Article
Date
Mar-1993
Author
N. Lynöe
B. Mattsson
M. Sandlund
Author Affiliation
Department of Social Medicine, University of Umeå, Sweden.
Source
Soc Sci Med. 1993 Mar;36(6):767-74
Date
Mar-1993
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude
Attitude of Health Personnel
Comparative Study
Complementary Therapies
Disclosure
Female
Humans
Male
Middle Aged
Paternalism
Patient Advocacy
Patients - psychology
Personal Autonomy
Physician-Patient Relations
Physicians - psychology
Placebos - therapeutic use
Qualitative Research
Research
Sweden
Trust
Abstract
Placebo treatment in clinical practice can be given either in order to comply with the wishes of the patient, or with the purpose of doing good and not causing harm. In the former instance, the procedure may be in accordance with the interests of the patient, yet be in conflict with the interests of the medical profession. In the latter instance, the procedure presupposes that in most cases the patient has not been informed of the nature of the treatment; this type of procedure may jeopardize a trusting patient-doctor relationship. Therefore, it is of interest to investigate both the extent to which patients and physicians feel they can accept placebo treatment and a paternalistic attitude, and in which particular situations. In order to shed some light on this matter, we compiled a questionnaire built around three case histories which problematize placebo treatment and paternalistic acts. The questionnaire was distributed to 100 patients and 100 physicians. 83 patients and 94 physicians responded. The results show that patients and physicians do not automatically follow specific group interests. Physicians are more inclined to respect the patient's option to refuse medical treatment than the patients are inclined to respect a physician's professional autonomy. Patients appear more to be paternalistic in their judgements than physicians, but one cannot rule out the possibility that the answers of the physicians reflect the fact that placebo treatment represent a socially undesirable behaviour. We conclude that theoretical and normative analyses of the perspective of the actors ought to be supplemented by empirical research.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
8480221 View in PubMed
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The Beta-Blocker Heart Attack Trial in perspective.

https://arctichealth.org/en/permalink/ahliterature12915
Source
Cardiology. 1983;70(5):255-62
Publication Type
Article
Date
1983
Author
S. Goldstein
Source
Cardiology. 1983;70(5):255-62
Date
1983
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Arrhythmia - prevention & control
Clinical Trials
Comparative Study
Death, Sudden - etiology
Double-Blind Method
Female
Heart Ventricles - physiopathology
Humans
Male
Middle Aged
Myocardial Infarction - complications - mortality
Norway
Placebos - therapeutic use
Propranolol - therapeutic use
Recurrence
Sotalol - therapeutic use
Timolol - therapeutic use
Abstract
Recently completed Beta-Blocker Heart Attack Trial in which propranolol was administered to patients following an acute myocardial infarction resulted in a 26% decrease in total mortality and a 23% decrease in total coronary events in the propranolol-treated patients as compared to the placebo patients during the average follow-up of 25 months. In addition to the decrease in mortality and morbidity, the drug was well tolerated in the patients treated with the drug when compared to those who received placebo. In the patients who received propranolol, there was a decreased incidence of ventricular arrhythmias. These results, coupled with the results of other trials using beta-adrenergic blocking agents including sotalol and timolol, strongly supports the beneficial effect of the routine administration of these beta blocking agents in the postmyocardial infarction patients.
PubMed ID
6141847 View in PubMed
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Placebos in clinical trials of psychotropic medication.

https://arctichealth.org/en/permalink/ahliterature208888
Source
Can J Psychiatry. 1997 Apr;42(3):6p.
Publication Type
Article
Date
Apr-1997
Author
D. Addington
R. Williams
Y. Lapierre
N. el-Guebaly
Author Affiliation
Department of Psychiatry, Foothills Hospital, Calgary AB.
Source
Can J Psychiatry. 1997 Apr;42(3):6p.
Date
Apr-1997
Language
English
Publication Type
Article
Keywords
Canada
Clinical Trials as Topic - methods
Ethics, Medical
Humans
Placebos - therapeutic use
Psychotropic Drugs - therapeutic use
Risk factors
Treatment Outcome
Abstract
This paper represents the position of the Canadian Psychiatric Association on the ethical and scientific issues related to the use of placebos in the evaluation of new psychotropic drugs. The position taken by the Association is that new psychotropic medications must be shown to be effective and must be weighed against the best current interventions. Placebo controls may be appropriate under certain circumstances, even when an established intervention is effective. These include situations in which placebo response rates are high, variable, or close to response rates for effective therapies. Placebo controls are also appropriate when established interventions carry a high risk of side effects or are effective against only certain symptoms of the disorder.
PubMed ID
9114950 View in PubMed
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A survey of placebo use in a general hospital.

https://arctichealth.org/en/permalink/ahliterature244216
Source
Gen Hosp Psychiatry. 1981 Sep;3(3):199-203
Publication Type
Article
Date
Sep-1981
Author
G. Gray
P. Flynn
Source
Gen Hosp Psychiatry. 1981 Sep;3(3):199-203
Date
Sep-1981
Language
English
Publication Type
Article
Keywords
Drug Utilization
Hospitals, General
Hospitals, University
Humans
Interviews as Topic
Nova Scotia
Placebos - therapeutic use
Questionnaires
Retrospective Studies
Abstract
Two hundred thirty registered nurses and seventy physicians participated in a retrospective study scrutinizing placebo effects, prescribing patterns, and staff attitudes in a university-based general hospital setting. Despite copious experimental literature devoted to placebo effects over the past thirty years, the medical and surgical use of placebos seems to disregard experimental data. Although 80% of the staff had used placebos in the hospital, their knowledge of placebo effects was in many respects deficient. Within the hospital, 89% of placebo use was directed toward the amelioration of "pain"; the authors believe that emphasis should be placed on the education of staff to perceive emotional, social, and physiological concomitants of pain rather than resorting to a purely physicalistic approach. A need to acknowledge staff conflicts over the ethical use of placebos should be a significant part of this educational approach.
PubMed ID
7286642 View in PubMed
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Treatment for a nondisease: the case of low blood pressure.

https://arctichealth.org/en/permalink/ahliterature243674
Source
Soc Sci Med. 1982;16(1):27-33
Publication Type
Article
Date
1982
Author
J M Robbins
H. Korda
M F Shapiro
Source
Soc Sci Med. 1982;16(1):27-33
Date
1982
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Hypotension - diagnosis - therapy
Male
Mass Screening
Placebos - therapeutic use
Quebec
Socioeconomic Factors
Abstract
This paper documents diagnosis and treatment of hypotension among a sample of subjects visiting blood pressure screening booths as part of a hypertension screening survey in Montreal. Of 1019 subjects, over one quarter had been diagnosed as hypotensive. Though low blood pressure is harmless for the majority of people, almost 10% of the screened sample reported receiving treatment from their physicians for the condition. Treatment typically consisted of harmless, but ineffective placebo-like medications including veal liver extract capsules or injections, iron capsules, tonics and vitamin B12 liquid, injections or capsules. Additional analysis discovered little meaningful difference in systolic and diastolic readings among individuals treated for hypotension, those diagnosed but not treated, and an undiagnosed group. Subjects receiving the hypotensive label from practitioners were typically older women with less education and income. Findings are discussed in light of the overlap between statistical and pathological models of illness; presenting symptoms of patients and their demands for treatment; and assumptions of physicians in diagnostic decision-making. It is speculated that medical definition of a nondisease such as low blood pressure may serve to individualize discomfort when true etiology lies in the environment; legitimate neglect of responsibilities and obligations by assigning one to the sick role; or cause organization of vague impulses into symptoms. Hypotension should be included in utilization studies to determine prevalence of treatment, life history of those being treated and complaints offered for treatment.
PubMed ID
7100954 View in PubMed
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The use of placebo interventions in medical practice--a national questionnaire survey of Danish clinicians.

https://arctichealth.org/en/permalink/ahliterature71330
Source
Eval Health Prof. 2003 Jun;26(2):153-65
Publication Type
Article
Date
Jun-2003
Author
Asbjørn Hróbjartsson
Michael Norup
Author Affiliation
Nordic Cochrane Centre, University of Copenhagen.
Source
Eval Health Prof. 2003 Jun;26(2):153-65
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Attitude of Health Personnel
Clinical Competence
Confidence Intervals
Denmark
Family Practice - standards - statistics & numerical data
Female
Humans
Infection - drug therapy
Male
Placebo Effect
Placebos - therapeutic use
Prescriptions, Drug
Questionnaires
Abstract
The authors sent a questionnaire to 772 randomly selected Danish clinicians and asked them about their use of placebo interventions. Sixty-five percent responded. Among the general practitioners, 86% (95% confidence interval 81-91) reported to have used placebo interventions at least once, and 48% (41-55) to have used placebo interventions more than ten times, within the last year. Hospital-based doctors and private specialists reported to have used placebo interventions less frequently (p
PubMed ID
12789709 View in PubMed
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7 records – page 1 of 1.