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Nocebo effects in clinical studies: hints for pain therapy
Regine Klinger1, Maxie Blasini2, Julia Schmitz1
1Department of Anesthesiology, Section Pain Therapy and Pain Psychology, Center for Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Pain Reports
|October 17, 2017
Summary
Healthcare providers can reduce nocebo effects, which worsen pain and reduce treatment effectiveness, by addressing patient-clinician communication and managing patient expectations. Understanding these factors improves pain management outcomes.
Area of Science:
- Pain Medicine
- Clinical Psychology
Background:
- Nocebo-induced algesic responses pose a significant challenge in pain medicine.
- These effects can negatively impact patient outcomes and treatment adherence.
Purpose of the Study:
- To develop ethically acceptable strategies for reducing nocebo responses in clinical settings.
- Focus on patient-practitioner interactions and contextual factors influencing nocebo effects.
Main Methods:
- Systematic review of clinical studies.
- Analysis of patient-practitioner interactions and their role in mitigating nocebo responses.
Main Results:
- Nocebo effects can decrease intervention efficacy and effectiveness.
- Altered pain perception and weakened treatment effects result from nocebo responses.
- Treatment nonadherence and discontinuation are promoted by nocebo effects.
Conclusions:
- Minimizing nocebo effects requires addressing communication, emotional burden, information, conditioning, and positive information deficits.
- Understanding these five aspects enables preventive, ethical clinical actions.
- Improving multidisciplinary pain treatment outcomes is achievable through these strategies.