title: Placebo use in the United kingdom: results from a national survey of primary care practitioners.
abstract: OBJECTIVE
  Surveys in various countries suggest 17% to 80% of doctors prescribe 'placebos' in routine practice, but prevalence of placebo use in UK primary care is unknown.
  
  
  METHODS
  We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into 'pure' and 'impure'. 'Impure' placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. 'Pure' placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks.
  
  
  RESULTS
  We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances.
  
  
  CONCLUSIONS
  Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.
authors.affiliation: Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom. Jeremy.howick@phc.ox.ac.uk
authors.forename: Jeremy
authors.initials: J
authors.lastname: Howick
authors.forename: Felicity L
authors.initials: FL
authors.lastname: Bishop
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
authors.forename: Jane
authors.initials: J
authors.lastname: Wolstenholme
authors.forename: Sarah
authors.initials: S
authors.lastname: Stevens
authors.forename: F D Richard
authors.initials: FD
authors.lastname: Hobbs
authors.forename: George
authors.initials: G
authors.lastname: Lewith
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D058007:Physicians, Primary Care; D010919:Placebos; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D010919:Placebos