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[Placebo and nocebo : How can they be used or avoided?]
E Hansen1, N Zech2, K Meissner3,4
1Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland. ernil.hansen@ukr.de.
Der Internist
|July 14, 2017
Summary
Patient expectations significantly influence treatment outcomes, triggering placebo and nocebo effects. Positive communication and managing expectations are crucial for optimizing therapeutic benefits and minimizing harm from adverse effects.
Area of Science:
- Psychoneuroimmunology
- Clinical Psychology
- Medical Ethics
Background:
- Patient expectations are key drivers of placebo and nocebo responses, impacting treatment efficacy.
- Placebo effects significantly contribute to both sham and real treatments, highlighting the power of positive suggestion.
- Nocebo effects manifest as real, harmful symptoms, often constituting a substantial portion of treatable side effects.
Purpose of the Study:
- To explore the mechanisms and impact of patient expectations on therapeutic outcomes.
- To emphasize the role of communication in modulating placebo and nocebo responses.
- To provide strategies for mitigating negative nocebo effects and enhancing positive placebo effects.
Main Methods:
- Review of existing literature on placebo and nocebo phenomena in clinical settings.
- Analysis of the influence of physician-patient communication and contextual factors.
- Examination of strategies for managing patient expectations and risk disclosure.
Main Results:
- Positive communication and managing expectations can significantly enhance treatment effectiveness.
- Nocebo effects are real physiological responses that can be prevented or neutralized.
- Physician-patient relationship, along with broader societal influences, shapes patient expectations.
Conclusions:
- Harnessing placebo effects through positive communication is vital for optimizing drug therapy.
- Awareness and proactive management of nocebo effects are essential for patient safety.
- Context-dependent factors, including physician communication and patient experiences, critically influence treatment outcomes.
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