Bandell DLJI, Kortlever JTP, Medina J, Ring D. How do people feel about the possibility that a treatment might not outperform simulated and inert treatments?
J Psychosom Res 2020;
131:109965. [PMID:
32086071 DOI:
10.1016/j.jpsychores.2020.109965]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/21/2020] [Accepted: 02/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND
Many treatments in common use are not proved better than simulated or inert treatments. While some clinicians express little concern about whether a particular treatment has a direct effect on the pathophysiology believed to be causing symptoms, we wonder if patients would agree.
QUESTIONS/PURPOSES
Are there factors independently associated with the affirmation that it is OK if a treatment is proved not to outperform simulated or inert treatment (a placebo) measured on an 11-point ordinal scale, including the risk and invasiveness of the treatment? And, are there factors independently associated with the affirmation that the clinician should inform a patient about the degree to which a given treatment is known to outperform simulated or inert treatments?
PATIENTS AND METHODS
We asked 763 English-speaking people their willingness to accept unproved treatment, depending on variations in risk, and invasiveness and their opinion regarding the importance of clinicians informing them whether a given treatment is proved to outperform simulated and inert (placebo) treatment.
RESULTS
Acceptance of the unproved treatment was quite low, more so with greater risk and invasiveness. Lower acceptance of unproved treatment was associated with older age, more education, and unemployment. People rated it quite important (mean 7.3 out of 10) that clinicians inform patients if treatments are no better than placebo, no matter the risk of the treatment.
CONCLUSIONS
People want to be informed if a treatment is not proved to outperform nonspecific effects such as the placebo effect.
LEVEL OF EVIDENCE
Not applicable.
Collapse