Perceptions of contribution of the placebo effects to drug efficacy in community pharmacy practice: A cross-sectional survey.

Abstract

Introduction: The placebo effect, a well-documented phenomenon in clinical practice, remains complex and multifaceted. While the perception of placebo effects has been assessed among various healthcare professionals, pharmacists - recognized experts in treatment effects and effectiveness - have not been specifically studied. This cross-sectional study aimed to evaluate the knowledge and perceptions of healthcare professionals working in community pharmacies in France, Switzerland, and Belgium regarding placebo effects.

Material and methods: A self-administered questionnaire was distributed to pharmacists, pharmacy technicians, and community pharmacy students between September and December 2023. The questionnaire used numeric scales (0-10) to evaluate knowledge of placebo effects, underlying mechanisms, influencing factors, and demographic details.

Results: A total of 377 responses were collected, primarily from female pharmacists practicing in France. Respondents demonstrated a strong theoretical understanding of placebo effects (n=302; 80%). Among 12 proposed contextual factors influencing placebo effects, the three most highly rated were patient-related: patient expectations and preferences, past experiences, and beliefs or representations about their condition. Perceptions of placebo effects varied significantly according to medication type, with median scores of 1 [0-3] for treatments with demonstrated efficacy, 3 [1-5] for conventional medicines without demonstrated efficacy, and 6 [4-9] for complementary and alternative medicines (CAM). This suggests that placebo-related efficacy is perceived as more associated with the type of medication (e.g., CAM vs. conventional medicines) rather than the presence or absence of demonstrated efficacy.

Conclusion: Pharmacists showed a solid theoretical grasp of placebo effects but seem to associate placebo-related efficacy more strongly with medication type than evidence of efficacy. These findings highlight the need to raise awareness among pharmacy-based healthcare professionals about treatment efficacy to improve clinical practice and patient care.