Interindividual variations in beliefs about the placebo effect: a study in 300 rheumatology inpatients and 100 nurses.
METHODS
Three hundred patients admitted to a rheumatology department (mean age, 49.2+/-15.5 years) and 100 nurses working in the same teaching hospital (mean age, 36+/-8.6 years) completed a questionnaire on the placebo effect in the treatment of pain.


RESULTS
The patients believed that the percentages of subjects who responded occasionally or consistently to a placebo were 32% (+/- 22%) and 21% (+/- 17%), respectively. The figures given by the nurses were only slightly higher: 42% (+/- 23%) and 23% (+/- 17%), respectively. Only 27% of the patients and 58% of the nurses knew that pain could resolve completely under placebo therapy. The mean percentage improvement induced by placebo therapy as compared to the study analgesic was estimated at 21% (+/- 17%) by the patients and 30% (+/- 18%) by the nurses. Only 23% of patients and 24% of nurses knew about nocebo effects.


CONCLUSIONS
These data suggest that during double-blind placebo-controlled trials three-quarters of the placebo arm patients who experience a marked improvement or a nocebo effect may believe they received the active drug. This is likely to reduce the difference between the placebo and active drug groups. Furthermore, most patients and nurses have a negative perception of placebo therapy. It may be useful to include a brief description of placebo and nocebo effects into the patient's information and informed consent documents used in double-blind placebo-controlled trials.
Rheumatology department, CHU Nantes, H teI-Dieu, Nantes, France.
J M
JM
Berthelot
Y
Y
Maugars
M
M
Abgrall
A
A
Prost
D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D015990:Placebo Effect; D012216:Rheumatic Diseases / Q000523:psychology* / Q000628:therapy*; D011795:Surveys and Questionnaires