Nav: Home

Australian GPs widely offering placebos, new study finds

December 02, 2019

Most Australian GPs have used a placebo in practice at least once, with active placebos (active treatments used primarily to generate positive expectations) more commonly used than inert placebos, according to a new study.

International studies indicate that placebo use by general practitioners (GPs) is remarkably high, but until now usage in Australia was unknown.

A new survey by Associate Professor Ben Colagiuri, in the School of Psychology at the University of Sydney, and Dr Kate Faasse at the University of New South Wales, examined rates of use and beliefs about placebos in Australian general practice. The findings are published today in the journal The Australian Journal of General Practice.

Key findings:
  • 77% of GPs had offered an active placebo (such as antibiotics for a virus)
  • 39% of GPs had offered an inert placebo (such as saline spray or a water-based cream)
  • GPs primarily used placebos because they believed they could provide genuine benefit and viewed themselves as having a strong role in shaping patients' expectations
  • 53% of GPs felt that administering placebos deceptively was unethical, but most (>80%) believed openly providing placebos - ie with the patient's knowledge - is ethical
  • GPs felt that medical trainees would benefit from more education about placebos
"We already know that doctors and GPs use placebos regularly overseas," Associate Professor Ben Colagiuri said. "So, we wanted to see what was happening in Australia. We found that placebo use is also relatively common here. The good news is that Australian GPs are predominantly using placebos because they believe that there's some real benefit to them. They are simply trying to help their patients."

The more concerning news, Associate Professor Colagiuri said, is that in some cases GPs are also prescribing antibiotics, an active medication, for purposes other than its design.

"The most common case is when a GP prescribes antibiotics when they know or strongly suspect that the patient doesn't have a bacterial infection," he said. "In these cases, they are prescribing antibiotics as a type of placebo, often because a patient expects or demands treatment. But antibiotics can have side effects and there are problems with antibiotic resistance if we prescribe antibiotics too much."

According to Associate Professor Colagiuri, one of the most important findings coming from the study is that GPs felt that medical trainees could benefit from more education about the placebo effect. "Currently, there are no guidelines on placebo use in clinical practice in Australia. As such, GPs and other medical professionals are left to make up their own minds as to if, at all, and how to use placebos. It is really important for medical professionals and patients that we develop evidenced-based guidelines for placebo use in Australia."

Co-author Dr Kate Faasse, from the School of Psychology at UNSW said the study found rates of placebo use by Australian GPs that were similar to those seen in other countries - the rates of use that we are seeing in the current study are very much in line with international research.

"Now we need more focus on understanding the role of psychological and social factors in physical health outcomes," Dr Faasse said. "There is so much more than just the active ingredients of a medicine, for example, that can help to improve people's health."

"In terms of future research, I think the possibility that we - either as individuals, or in medical contexts - can be harnessing the placebo effect in our own lives by knowingly using 'open-label' placebos is fascinating," Dr Fasse said. "Figuring out the best way to do this, for example what information helps open-label placebos be most effective, in what dose, and for what outcomes, are really fascinating research questions that we're starting to explore."

What is a placebo?

A placebo is a treatment that works because the patient expects it to. Placebos have been found to produce genuine therapeutic benefit in conditions ranging from pain, nausea and sleep, to hypertension, immune function and even Parkinson's disease.

An inert placebo treatment is something that has no active ingredients whatsoever, such as a sugar pill, saline nasal spray or a water-based cream. An active placebo treatment is one that contains active ingredients - an antibiotic or cough mixture - but is unlikely to have a specific physiological effect on the patient's current condition.

What is the placebo effect?

The placebo effect occurs when the patient believes a treatment will help them to feel better. These beliefs trigger changes in the central nervous system - such as the release of neurotransmitters in our brains - that actually cause improvement. Usually placebos involve deception, that is the patient is led to believe that they are receiving an active treatment. However, recent studies have shown that the placebo effect can happen even when the patient knows they are receiving a placebo. The vast majority of Australian GPs - more than 80 per cent - believe that giving a placebo openly, without deception, is ethical.
-end-
The study

The study published in the journal The Australian Journal of General Practice involved a random sample of 136 GPs from around Australia who completed a brief online survey which asked them about placebo use and their beliefs about placebo treatments.

Declaration: Funding: Dr Faasse is supported by an Australian Research Council Discovery Early Career Researcher Award (DE180100471). Associate Professor Colagiuri was supported by an Australian Research Council Discovery Early Career Researcher Award (DE160100864) while conducting this research. The funder played no part in the study design, data collection, analysis, or interpretation. The researchers are independent from the funder.

University of Sydney

Related Antibiotics Articles:

Hygiene reduces the need for antibiotics by up to 30%
A new paper published in the American Journal of Infection Control (AJIC), finds improved everyday hygiene practices, such as hand-washing, reduces the risk of common infections by up to 50%, reducing the need for antibiotics, by up to 30%.
Antibiotics: City dwellers and children take the most
City dwellers take more antibiotics than people in rural areas; children and the elderly use them more often than middle-aged people; the use of antibiotics decreases as education increases, but only in rich countries: These are three of the more striking trends identified by researchers of the NRW Forschungskolleg ''One Health and Urban Transformation'' at the University of Bonn.
Metals could be the link to new antibiotics
Compounds containing metals could hold the key to the next generation of antibiotics to combat the growing threat of global antibiotic resistance.
Antibiotics from the sea
The team led by Prof. Christian Jogler of Friedrich Schiller University, Jena, has succeeded in cultivating several dozen marine bacteria in the laboratory -- bacteria that had previously been paid little attention.
Antibiotics not necessary for most toothaches, according to new ADA guideline
The American Dental Association (ADA) announced today a new guideline indicating that in most cases, antibiotics are not recommended for toothaches.
Antibiotics with novel mechanism of action discovered
Many life-threatening bacteria are becoming increasingly resistant to existing antibiotics.
Resistance can spread even without the use of antibiotics
Antibiotic resistance does not spread only where and when antibiotics are used in large quantities, ETH researchers conclude from laboratory experiments.
Selective antibiotics following nature's example
Chemists from Konstanz develop selective agents to combat infectious diseases -- based on the structures of natural products
Antibiotics can inhibit skin lymphoma
New research from the LEO Foundation Skin Immunology Research Center at the University of Copenhagen shows, surprisingly, that antibiotics inhibit cancer in the skin in patients with rare type of lymphoma.
Antibiotics may treat endometriosis
Researchers at Washington University School of Medicine in St. Louis have found that treating mice with an antibiotic reduces the size of lesions caused by endometriosis.
More Antibiotics News and Antibiotics Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Meditations on Loneliness
Original broadcast date: April 24, 2020. We're a social species now living in isolation. But loneliness was a problem well before this era of social distancing. This hour, TED speakers explore how we can live and make peace with loneliness. Guests on the show include author and illustrator Jonny Sun, psychologist Susan Pinker, architect Grace Kim, and writer Suleika Jaouad.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.