J Pediatr. 2016 Nov 9. pii: S0022-3476(16)31086-1. doi: 10.1016/j.jpeds.2016.10.018. [Epub ahead of print]

Parental Attitudes About Placebo Use in Children.

Faria V1, Kossowsky J2, Petkov MP3, Kaptchuk TJ4, Kirsch I4, Lebel A3, Borsook D3.

Author information

• 1Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Psychology, Uppsala University, Uppsala, Sweden; Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: vanda.rochafaria@childrens.harvard.edu.
• 2Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA; Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.
• 3Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
• 4Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Abstract

OBJECTIVE:

To assess parental attitudes regarding placebo use in pediatric randomized controlled trials and clinical care.

STUDY DESIGN:

Parents with children under age 18 years living in the US completed and submitted an online survey between September and November 2014.

RESULTS:

Among all 1300 participants, 1000 (76.9%; 538 mothers and 462 fathers) met the study inclusion criteria. The majority of surveyed parents considered the use of placebos acceptable in some pediatric care situations (86%) and some pediatric trials (91.5%), whereas only 5.7% of parents found the use of placebos in children always unacceptable. The clinical use of placebo was considered acceptable by a majority of parents for only 7 (mostly psychological) of the 17 conditions presented. Respondents' judgment about acceptability was influenced by the doctors' opinions about the therapeutic benefits of placebo treatment, the conditions for pediatric placebo use, transparency, safety, and purity of placebos.

CONCLUSION:

Most surveyed parents accepted the idea of using placebos in pediatric trials and within the clinic for some conditions without the practice of deception and with the creation of guidelines for ethical and safe use. This study suggests a need to reconsider pediatric trial design and clinical therapy in the light of generally positive parental support of appropriate placebo use.