title: Widespread use of pure and impure placebo interventions by GPs in Germany.
abstract: OBJECTIVE
  To collect data on the use of placebo interventions by GPs in Germany.
  
  
  METHODS
  A questionnaire was mailed to 400 randomly selected GPs in Bavaria. Non-responders were reminded by telephone after 4 weeks and were given a second copy of the questionnaire after a further 3 weeks.
  
  
  RESULTS
  In all, 208 completed questionnaires were returned. The majority of GPs (88%) have used a placebo at least once in their practice; 45% have used pure placebos, such as saline injections and sugar pills, at least once last year; the median frequency of use was 5 [interquartile range (IQR), 2-10]. The use of impure placebos during the past year was more common: 76% of GPs have used impure placebos, i.e. medical interventions that have pharmacological or physical activity but have no intrinsic effect (e.g. pharmacological or physical action) on the patient's disease or its symptoms, with a median frequency of 20 times per year (IQR, 10-50). The main reason for the use of placebo was a possible psychological effect, followed by the expectation of patients to receive a treatment. For the majority of GPs placebo interventions were ethically justified if they were used for a possible psychological effect.
  
  
  CONCLUSIONS
  Placebo interventions are a widely accepted part of medical treatment in German general practices and are used primarily for their psychological effects. Impure placebos are used much more frequently than pure placebos.
authors.affiliation: Institute of Medical Psychology, Ludwig-Maximilians-University of Munich, Goethestrasse 31, 80336 Munich, Germany. karin.meissner@med.lmu.de
authors.forename: Karin
authors.initials: K
authors.lastname: Meissner
authors.forename: Lisa
authors.initials: L
authors.lastname: Höfner
authors.forename: Margrit
authors.initials: M
authors.lastname: Fässler
authors.forename: Klaus
authors.initials: K
authors.lastname: Linde
mesh_terms: D005260:Female; D058006:General Practice; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D010919:Placebos