Perceptions of contribution of the placebo effects to drug efficacy in community pharmacy practice: A cross-sectional survey - 02/04/25

Doi : 10.1016/j.therap.2025.02.015

Joey Fournier ^a,^b, Leo Druart ^c,^d, Marie Allier ^a, Matthieu Roustit ^a,^b,⁎
^a Inserm CIC 1406, Grenoble Alpes University Hospital, University Grenoble-Alpes, 38000 Grenoble, France
^b Inserm U1300, HP2, University Grenoble-Alpes, 38000 Grenoble, France
^c Department of Diagnostic Imaging, Warren-Alpert Medical School, Brown University, Providence, RI 02903, United States
^d Rhode Island Hospital, Brown University Health, Providence, RI 02903, United States

^⁎Corresponding author. Service de méthodologie et de pharmacologie clinique, centre d’investigation clinique, CHU Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France.Service de méthodologie et de pharmacologie clinique, centre d’investigation clinique, CHU Grenoble-AlpesCS 10217Grenoble cedex 938043France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 02 April 2025

Summary

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.

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Keywords : Placebo effects, Pharmacists, Community pharmacy services, Health knowledge, Attitudes, Practice, Professional practice, Cross-sectional studies