title: Patient attitudes about the clinical use of placebo: qualitative perspectives from a telephone survey.
abstract: OBJECTIVE
  To examine qualitative responses regarding the use of placebo treatments in medical care in a sample of US patients.Survey studies suggest a deliberate clinical use of placebos by physicians, and prior research has found that although most US patients find placebo use acceptable, the rationale for these beliefs is largely unknown.
  
  
  METHODS
  Members of the Outpatient Clinic at the Kaiser Permanente Northern California interviewed research participants who had been seen for a chronic health problem at least once in the prior 6 months.
  
  
  METHODS
  853 women (61%) and men, white (58%) and non-white participants aged 18-75 years.
  
  
  METHODS
  Qualitative responses on perceptions of placebo use from one-time telephone surveys were analysed for common themes and associations with demographic variables.
  
  
  RESULTS
  Prior results indicated that a majority of respondents felt it acceptable for doctors to recommend placebo treatments. Our study found that a lack of harm (n=291, 46.1%) and potential benefit (n=250, 39.6%) were the most common themes to justify acceptability of placebo use. Responses citing potential benefit were associated with higher education (r=0.787; p<0.024). Of the minority of respondents who judged it never acceptable for doctors to recommend placebo treatments, the most often referenced rationale was obligation of the doctor to do more (n=102, 48.3%). Additional themes emerged around the issue of whether a doctor was transparent about placebo use, including honesty, patient's right to know and power of the mind. Older age was associated with likelihood to cite overall physician, as opposed to treatment, related themes (r=0.753; p<0.002).
  
  
  CONCLUSIONS
  Participants seem to appreciate and understand the lack of harm and potential benefit associated with placebo treatments, while valuing the role of the physician and the patient in its implementation.
authors.affiliation: Medicine-Pediatrics Residency Program, Johns Hopkins Hospital, Baltimore, MD and National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Ortiz
authors.affiliation: National Institutes of Health and Department of Bioethics, Office of the Scientific Director, National Human Genome Research Institute, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Chandros Hull
authors.affiliation: Department of Pain Translation Symptom Science; School of Medicine, Department of Anesthesiology, University of Maryland, School of Nursing, Center to Advance Chronic Pain Research (CACPR), Baltimore, Maryland, USA.
authors.forename: Luana
authors.initials: L
authors.lastname: Colloca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002140:California; D002908:Chronic Disease; D032882:Comprehension; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026441:Mind-Body Therapies; D028701:Patient Rights; D010817:Physician-Patient Relations; D010820:Physicians; D015990:Placebo Effect; D010919:Placebos / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D035502:Trust; D055815:Young Adult
chemical_list: D010919:Placebos
keywords: Deception; Doctor-patient relationship; Patients' view; Placebo; Placebo effects; Trust