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Health emergencies and interoceptive sensibility modulate the perception of non-evidence-based drug use: Findings from the COVID-19 outbreak.
Salvato, Gerardo; Ovadia, Daniela; Messina, Alessandro; Bottini, Gabriella.
  • Salvato G; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
  • Ovadia D; Cognitive Neuropsychology Centre, ASST "Grande Ospedale Metropolitano" Niguarda, Milano, Italy.
  • Messina A; NeuroMi, Milan Center for Neuroscience, Milan, Italy.
  • Bottini G; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
PLoS One ; 16(8): e0256806, 2021.
Article in English | MEDLINE | ID: covidwho-1808553
ABSTRACT
Scientific evidence plays an important role in the therapeutic decision-making process. What happens when physicians are forced to make therapeutic decisions under uncertainty? The absence of scientific guidelines at the beginning of a pandemic due to an unknown virus, such as COVID-19, could influence the perceived legitimacy of the application of non-evidence-based therapeutic approaches. This paper reports on a test of this hypothesis, in which we administered an ad hoc questionnaire to a sample of 64 Italian physicians during the first wave of the COVID-19 pandemic in Italy (April 2020). The questionnaire statements regarding the legitimacy of off-label or experimental drugs were framed according to three different scenarios (Normality, Emergency and COVID-19). Furthermore, as the perception of internal bodily sensations (i.e., interoception) modulates the decision-making process, we tested participants' interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). The results showed that participants were more inclined to legitimate non-evidence-based therapeutic approaches in the COVID-19 and Emergency scenarios than the Normality scenario. We also found that scores on the MAIA Trusting subscale positively predicted this difference. Our findings demonstrate that uncertain medical scenarios, involving a dramatic increase in patient volume and acuity, can increase risk-taking in therapeutic decision-making. Furthermore, individual characteristics of health care providers, such as interoceptive ability, should be taken into account when constructing models to prevent the breakdown of healthcare systems in cases of severe emergency.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Physicians / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0256806

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Physicians / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0256806