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BMJ 2004;329:944-946 (23 October), doi:10.1136/bmj.38236.646678.55 (published 17 September 2004)
Uriel Nitzan, medical student1, Pesach Lichtenberg, lecturer1
1 Herzog Hospital and Hadassah School of Medicine, Department of Psychiatry, POB 35300, Jerusalem 91351, Israel
Correspondence to: P Lichtenberg licht{at}cc.huji.ac.il
Objectives To gauge the frequency and circumstances of use of placebo in clinical practice and the attitudes towards its use among those who administer it.
Design Retrospective questionnaire.
Setting Two large hospitals and various community clinics in the Jerusalem area.
Participants 31 physicians working in hospital inpatient and outpatient departments, 31 head nurses working in hospital inpatient departments, and 27 family physicians working in community clinics.
Main outcome measures Self report of frequency and circumstances of, and attitudes towards, use of placebo.
Results Among the 89 respondents, 53 (60%) used placebos (95% confidence interval 49% to 70%). Among users, 33 (62%) prescribed a placebo as often as once a month or more; 36 (68%) told patients they were receiving actual medication; 15 (28%) considered that placebos were a diagnostic tool; and 48/51 (94%) reported that they found placebos generally or occasionally effective.
Conclusion Most practitioners questioned in this study continue to use placebos. Used wisely, placebos might have a legitimate place in therapeutics. Wider recognition of the practice and debate about its implications are imperative.
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