Tag Archives: Research

GPs use placebos

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An interesting distinction  between ‘pure’ and impure’ placebos! (Universal Placebos are unapologetically PURE!)

“A pure placebo is a straightforwardly fake treatment – a saline injection or a sugar pill, for instance, that is represented as a drug.

An impure placebo is a substance or treatment that does have clinical value, but not for the condition for which it is being prescribed.

Impure placebos can be vitamins, nutritional supplements, antibiotics for viral infections, sub-clinical doses of drugs, unproven complementary and alternative medicines, or unnecessary blood tests to calm an anxious patient.”

A UK survey in 2012 showed that 1% of GPs use ‘pure’ placebos at least once a week, and an extraordinary 77% use ‘impure’ placebos at the same rate (though we suspect that’s often the habit of prescribing so-called ‘useless’ antibiotics for viral infections).

Legitimising alternatives!? No way! Well … maybe …

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“Britain’s Princess Alexandra Hospital NHS Trust wants to hire a reiki therapist for a hospital in Epping.”

This caused a controversy and a flurry of disgruntled email. BUT …

“If drugs are effective and placebo responses small, this does not matter much. But people tend to turn to alternative medicine for subjective, stress-related conditions such as chronic pain, depression, nausea and fatigue (all problems that can affect cancer patients in treatment). Drugs for these conditions have significant downsides, such as unpleasant side effects and addiction, and placebo responses often account for most of the effect of the drug. So it becomes plausible that compared to popping a pill, a patient might get more relief — and fewer side effects — from an hour with a sympathetic therapist.”

 

“When effective drugs do exist, placebo effects can enhance their impact.”

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More research from Ted Kaptchuk, in the New England Journal of Medicine.

“Placebos don’t necessarily provide cures, but they provide relief. In medical situations in which no cure is available, supportive and attentive health care can help patients to feel better, and when effective drugs do exist, placebo effects can enhance their impact.”

And …

“A significant body of research has resulted in a shift from thinking of placebos as just ‘dummy’ treatments to recognizing that placebo effects encompass numerous aspects of the health care experience and are central to medicine and patient care. Recent scientific advances have enabled us to identify a trove of neurotransmitters and detect relevant neural brain pathways as well as genetic markers that help explain the biology of the placebo effect.”

More reviews of the research here and here.