Patients' attitudes to the use of placebos: results from a New Zealand survey

Abstract

Aims: To examine how amenable patients are to the use of placebos in clinical practice, their willingness to participate in a placebo-controlled clinical trial (PCT), and to examine patients' beliefs about the placebo effect.

Methods: A cross-sectional questionnaire survey was administered to 211 general practice patients of two primary care clinics in socioeconomically divergent areas of the Auckland region, New Zealand. The questionnaire obtained self-report of willingness to accept various clinical uses of placebo as measured by the Attitudes to Placebo Treatments Scale (APTS), willingness to participate in a PCT including reasons for or against participation, and beliefs about the placebo effect.

Results: The APTS score (M=22.34, SD=7.93) for the entire sample showed that patients were accepting of placebo use in certain clinical situations, even the use of placebo as a diagnostic tool. Patients seem to consider placebo use more appropriate when it is for the benefit of the patient, at the patient's request, or when there seems to be no available alternate treatment. Placebo use was considered inappropriate when its use was seen to be for the benefit(s) of the physician or where placebo use seemed dangerous. 59% of the patients surveyed indicated willingness to participate in a PCT.

Conclusion: Many patients are amenable to the use of placebos, suggesting that the major issues of placebo use (deception and lack of informed consent) are tolerated by the patients surveyed. Many were prepared to participate in a PCT particularly in order to support the development of new treatment and help other patients. However, patients seem to have misguided beliefs about the placebo effect, underestimating the effectiveness of the placebo and attributing placebo effects to personality. Generally, patients lack understanding of the placebo effect.