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Friday, 22 March 2013

If common sense was a drug, would it be a placebo?

Have you read the Placebo Effect Study which was recently subject to much animated discussion?

Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners


In the survey, the doctors were asked if they used "pure" and "impure" placebos. 

"Pure" placebos were defined as interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated.

"Impure" placebos were defined as substances, interventions or ‘therapeutic’ methods which have known pharmacological, clinical or physical value for some ailments but lack specific therapeutic effects or value for the condition for which they have been prescribed.



These may include:
  • Positive suggestions
  • Nutritional supplements for conditions unlikely to benefit from this therapy (such as vitamin C for cancer)
  • Probiotics for diarrhoea
  • Peppermint pills for pharyngitis
  • Antibiotics for suspected viral infections 
  • Sub-clinical doses of otherwise effective therapies 
  • Off-label uses of potentially effective therapies
  • Complementary and Alternative medicine (CAM) whose effectiveness is not evidence-based 
  • Conventional medicine whose effectiveness is not evidence-based 
  • Diagnostic practices based on the patient's request or to calm the patient such as non-essential physical examinations or non-essential technical examinations of the patient (blood tests, X-rays)
Here is the result: 

12% of family doctors used pure placebos while 97% family doctors used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% used impure placebos at least once per week. Most respondents stated placebos were ethical in some circumstances.

So 97 out of 100 general practitioners believe that sometimes remedies work because they just do; that different remedies may work for different people in different situations, and that positive suggestion can help healing.

That's the good news. The bad news is that, apparently, the doctors could be breaking regulations if they were "caught". 

If common sense was a drug, it probably would be a placebo too. 

Time to change the regulations?  

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