How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.

BACKGROUND:In a systematic review and meta-analysis we summarize the available evidence on how frequently general practitioners/family physicians (GPs) use pure placebos (e.g., placebo pills) and non-specific therapies (sometimes referred to as impure placebos; e.g., antibiotics for common cold). ME...

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Main Authors: Klaus Linde, Oxana Atmann, Karin Meissner, Antonius Schneider, Ramona Meister, Levente Kriston, Christoph Werner
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6108457?pdf=render
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spelling doaj-02b3f37115004153be282aee7ed6fe5e2020-11-25T01:57:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01138e020221110.1371/journal.pone.0202211How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.Klaus LindeOxana AtmannKarin MeissnerAntonius SchneiderRamona MeisterLevente KristonChristoph WernerBACKGROUND:In a systematic review and meta-analysis we summarize the available evidence on how frequently general practitioners/family physicians (GPs) use pure placebos (e.g., placebo pills) and non-specific therapies (sometimes referred to as impure placebos; e.g., antibiotics for common cold). METHODS:We searched Medline, PubMed and SCOPUS up to July 2018 to identify cross-sectional quantitative surveys among GPs. Outcomes of primary interest were the percentages of GPs having used any placebo, pure placebos or non-specific therapies at least once in their career, at least once in the last year, at least monthly or at least weekly. Outcomes were described as proportions and pooled with random-effects meta-analysis. RESULTS:Of 674 publications, 16 studies from 13 countries with a total of 2.981 participating GPs (range 27 to 783) met the inclusion criteria. The percentage of GPs having used any form of placebo at least once in their career ranged from 29% to 97%, in the last year at least once from 46% to 95%, at least monthly from 15% to 89%, and at least weekly from 1% to 75%. The use of non-specific therapies by far outnumbered the use of pure placebo. For example, the proportion of GPs using pure placebos at least monthly varied between 2% and 15% compared to 53% and 89% for non-specific therapies; use at least weekly varied between 1% and 3% for pure placebos and between 16% and 75% for non-specific therapies. Besides eliciting placebos effects, many other reasons related to patient expectations, demands and medical problems were reported as reasons for applying placebo interventions. CONCLUSION:High prevalence estimates of placebo use among GPs are mainly driven by the frequent use of non-specific therapies; pure placebos are used rarely. The interpretation of our quantitative findings is complicated by the diversity of definitions and survey methods.http://europepmc.org/articles/PMC6108457?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Klaus Linde
Oxana Atmann
Karin Meissner
Antonius Schneider
Ramona Meister
Levente Kriston
Christoph Werner
spellingShingle Klaus Linde
Oxana Atmann
Karin Meissner
Antonius Schneider
Ramona Meister
Levente Kriston
Christoph Werner
How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.
PLoS ONE
author_facet Klaus Linde
Oxana Atmann
Karin Meissner
Antonius Schneider
Ramona Meister
Levente Kriston
Christoph Werner
author_sort Klaus Linde
title How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.
title_short How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.
title_full How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.
title_fullStr How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.
title_full_unstemmed How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys.
title_sort how often do general practitioners use placebos and non-specific interventions? systematic review and meta-analysis of surveys.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2018-01-01
description BACKGROUND:In a systematic review and meta-analysis we summarize the available evidence on how frequently general practitioners/family physicians (GPs) use pure placebos (e.g., placebo pills) and non-specific therapies (sometimes referred to as impure placebos; e.g., antibiotics for common cold). METHODS:We searched Medline, PubMed and SCOPUS up to July 2018 to identify cross-sectional quantitative surveys among GPs. Outcomes of primary interest were the percentages of GPs having used any placebo, pure placebos or non-specific therapies at least once in their career, at least once in the last year, at least monthly or at least weekly. Outcomes were described as proportions and pooled with random-effects meta-analysis. RESULTS:Of 674 publications, 16 studies from 13 countries with a total of 2.981 participating GPs (range 27 to 783) met the inclusion criteria. The percentage of GPs having used any form of placebo at least once in their career ranged from 29% to 97%, in the last year at least once from 46% to 95%, at least monthly from 15% to 89%, and at least weekly from 1% to 75%. The use of non-specific therapies by far outnumbered the use of pure placebo. For example, the proportion of GPs using pure placebos at least monthly varied between 2% and 15% compared to 53% and 89% for non-specific therapies; use at least weekly varied between 1% and 3% for pure placebos and between 16% and 75% for non-specific therapies. Besides eliciting placebos effects, many other reasons related to patient expectations, demands and medical problems were reported as reasons for applying placebo interventions. CONCLUSION:High prevalence estimates of placebo use among GPs are mainly driven by the frequent use of non-specific therapies; pure placebos are used rarely. The interpretation of our quantitative findings is complicated by the diversity of definitions and survey methods.
url http://europepmc.org/articles/PMC6108457?pdf=render
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