The placebo in practice: how to use it in clinical routine

Recent placebo literature provides the scientific basis for the different psychological factors that influence the outcome of a medical treatment. The aim of the present review is to summarize the recent findings of placebo research offering useful tools for everyday medical routine.

Treatment efficacy is influenced by the patient's expectations of therapeutic benefit. Indeed, positive or negative expectations may lead to symptom improvement or worsening, respectively. Therefore, in clinical practice, patients' expectations and beliefs need to be considered and controlled appropriately. In addition, previous experience influences the healing process, as shown by classical conditioning studies. This knowledge can be used to increase the effect of pharmacological or procedural treatments, to reduce drug intake, and to minimize psychological adverse events. Overall, a significant enhancement of the therapeutic outcome can be obtained by potentiating empathic communication and establishing a cooperative patient-provider relationship.

Placebo research provides solid scientific ground for all those psychological aspects that characterize every medical treatment. It also gives us information on the functioning of the human brain, with the possibility to exploit some of these mechanisms in routine medical practice.