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Attitudes of Mexican family doctors regarding the use of placebos in clinical practice

Issa Gil-Alfaro, Gad Gamed Zavala-Cruz, Azucena Maribel Rodríguez-González, José Manuel Ramírez-Aranda
2019 Gaceta Médica de México  
The use of placebo has spread in clinical practice despite being controversial. In Mexico, the practice of family medicine is predominantly institutional and works with an essential medications list. Objective: To determine the frequency and family doctor attitude regarding the use of placebos in clinical practice. Method: Cross-sectional, observational, multicenter study of 307 family doctors with active practice in 27 states of the Mexican Republic. A questionnaire was used with
more » ... with sociodemographic data and consensus-developed questions about frequency of use and attitudes. For analysis, the square-chi test was used. Results: 75 % used placebos (95 % CI=69.7-79.4%); 122 (39.7%) used pure placebos, mainly water (p < 0.05), and 220 (71.6%), impure placebos, mainly vitamins and laboratory tests. They were used more in patients with medically unexplained physical symptoms (178, 45.5%), including 122 (31.2%) "healthy worried" patients, or who had chronic conditions (40, 12.5%). Reasons for prescription: 249 (81%) for the psychological effect, when they showed benefit (176, 57%), even when it implied deceiving (78, 25%) or insufficient evidence of efficacy (57, 19%). The main reason was because of patient insistence. Conclusions: More impure placebos were used, mainly in healthy worried patients and in those with chronic conditions. KEY WORDS: Placebos. Placebo effect. Family medicine. Community-based medicine. Primary health care. Gaceta Médica de México
doi:10.24875/gmm.m19000299 fatcat:dpa5u32aozawtlcb4hcjs63nfq