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- Blease, Charlotte
(författare)
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The role of placebos in family medicine : Implications of evidence and ethics for general practitioners
- 2019
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Ingår i: Australian Journal of General Practice. - : Royal Australian College of General Practitioners. - 2208-794X .- 2208-7958. ; 48:10, s. 700-705
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPlacebo use is prevalent in primary care. A wealth of discourse on the ethical use of placebos in clinical contexts invariably assumes that placebos oblige practitioners to peddle in deception. However, the recent surge in empirical findings within the field of 'placebo studies' provides a very different perspective: namely, that placebos may yet prove to be both effective and ethical.ObjectiveThe aim of this article is to synthesise state-of-the-art scientific and bioethical research to provide up-to-date recommendations on placebo use for general practitioners.DiscussionAfter disambiguating placebo concepts, this article outlines experimental studies into placebo effects and explores the ethical and evidence-based arguments for prescribing placebos. Evaluating the latest research into 'open-label placebos', it can be surmised that there are not yet persuasive grounds to incorporate these treatments into routine clinical care. Notwithstanding, the quality of physician interactions may go some way to harnessing remedial placebo effects among patients.
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| 2. |
- Gunnarsson, Ronny K, 1955, et al.
(författare)
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Improving antibiotics targeting using PCR point-of-care testing for group A streptococci in patients with uncomplicated acute sore throat
- 2021
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Ingår i: Australian Journal of General Practice. - 2208-794X .- 2208-7958. ; 50:1-2, s. 76-83
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective Evidence supports some beneficial effects of antibiotics prescribed to patients with a sore throat and proven presence of group A streptococci (GAS). Methods A total of 283 patients were included from North and North-West Queensland, Australia, at their first presentation for uncomplicated acute sore throat. Patterns of antibiotic prescribing were explored before and after testing for GAS using a rapid point-of-care polymerase chain reaction (PCR) test. Results The results of the study showed the Australian Therapeutic Guidelines were often not adhered to. The PCR test reduced the proportion of patients prescribed antibiotics from 46% to 40%. The decision to prescribe antibiotics was changed in 30% of patients (P <0.001): before testing only 40% of patients prescribed antibiotics had a positive GAS PCR while this increased to 97% after testing. Discussion An easy-to-use point-of-care test to detect GAS allows better targeting of antibiotic prescribing in patients with an uncomplicated acute sore throat.
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| 4. |
- Balch, Graeme, et al.
(författare)
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Oral corticosteroids for painful acute otitis externa (swimmer's ear): A triple-blind randomised controlled trial.
- 2019
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Ingår i: Australian journal of general practice. - 2208-7958. ; 48:8, s. 565-572
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Tidskriftsartikel (refereegranskat)abstract
- Acute otitis externa is often painful. The aim of this study was to evaluate the efficacy of 10 mg oral prednisolone twice daily for four days in addition to conventional therapy.Patients attending general practice clinics in Far North Queensland, Australia, for acute painful otitis externa were given a study capsule with either 10 mg prednisone or placebo.Seventy-three patients were randomised. Results from 19 patients in the intervention group and 11 patients in the control group were analysed. Oral corticosteroids did not decrease the time to being completely pain-free but decreased the time for pain to reduce from more than 'moderate pain' to less than 'moderate pain', from 3.7 days to 2.4 days (P= 0.012, log rank test).Oral corticosteroids seem to be effective in reducing more than 'moderate pain' to less than 'moderate pain'. However, this result needs to be confirmed in a larger trial.
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