A prescrição de medicamentos com 'intenção placebo' e a autoperceção de ser médico capacitante na Região Centro de Portugal: estudo em ciclo de garantia de qualidade ; Prescription with placebo intention and physicians' self-assessed enablement in Center Region of Portugal

Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina ; Background: The evidence shows that doctors often use medicines with “placebo intention” to treat their patients. The use of patient-centred medicine and a good doctor-patient relationship increases patient’s enablement.Objectives: The goal of this study is to understand the difference in the perception that doctors had about their competence to empower and the prescription with “placebo intention” after intermediate information.Methods: An analytical study was carried out in a quality assurance cycle. Two questionnaires were applied (prescription of drugs with “placebo intention” and enablement) in two phases one year apart (September 2019 and October 2020). The samples consisted of General Practice Physicians, tutors in the Faculty of Medicine of the University of Coimbra. Throughout the COVID19 pandemic break year, online training and information was given on both topics. For the descriptive analysis and statistical inference of the data, the SPSS Software for Windows program (version 24) was used. The normality of the data was verified, and the chi-square test and Mann-Whitney U test were performed, with a statistically significant value for p<0,05.Results: The sample consisted in 60 doctors in 2019 and 31 doctors in 2020. In both years, 70% of doctors were women. It was of 55,0% and of 53,3% the proportion of doctors who admitted prescribing medication with “placebo intention” in 2019 and 2020, respectively (∆ = -3,1). The item regarding placebo prescription "allowed if scientific evidence of therapeutic efficacy" was the only one with a significant difference (p=0,004) between both times. In the enablement questionnaire, there was a significant difference between the two phases of application regarding the use of competence (p=0,009), exemplification (p=0,068) and andragogy (p=0,026) better in the second time. Most items were "almost always" used by doctors in their consultations.Discussion: The proportion of ...