Characterizing the perception of the placebo effect in sports medicine

Objective: To characterize differences in the perception and understanding of the placebo effect between sports physicians, coaches, athletes, and sports science personnel. Design: A short 11-item questionnaire was administered addressing demographic details, understanding of the placebo effect, and willingness to use the effect in an elite sport setting. Setting: All participants were involved in national level sporting programs. Participants: A total of 187 individuals (17 sports physicians, 44 sports scientists, 30 national-level coaches, and 96 national-level athletes) completed the questionnaire. All participants were contacted and invited to participate voluntarily. INTERVENTIONS/ Assessment of risk factors: Not applicable. Main outcome measurements: Self-reported responses on understanding and use of placebo effect in sport. Results: A total of 94% of physicians and 98% of scientists, but only 44% of athletes, indicated a good understanding of the placebo effect. A majority of scientists (63%) and physicians (59%) administered placebo at least once a year. Most of scientists (95%) and a majority of physicians (71%) either mildly or strongly encouraged use of the placebo in their clinical practice. About 60% of athletes indicated they would not care if they were unknowingly administered a placebo: however, 30% of them would not appreciate being misled. Conclusions: There is a substantial difference in the level of understanding of the placebo effect between physicians and athletes in elite sport. Although athletes are willing to use the placebo effect, physicians need to be mindful of the manner of its implementation.