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    What Should Clinicians Tell Patients about Placebo and Nocebo Effects? Practical Considerations Based on Expert Consensus

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    Author
    Evers, Andrea W M
    Colloca, Luana
    Blease, Charlotte
    Gaab, Jens
    Jensen, Karin B
    Atlas, Lauren Y
    Beedie, Chris J
    Benedetti, Fabrizio
    Bingel, Ulrike
    Büchel, Christian
    Bussemaker, Jet
    Colagiuri, Ben
    Crum, Alia J
    Finniss, Damien G
    Geers, Andrew L
    Howick, Jeremy
    Klinger, Regine
    Meeuwis, Stefanie H
    Meissner, Karin
    Napadow, Vitaly
    Petrie, Keith J
    Rief, Winfried
    Smeets, Ionica
    Wager, Tor D
    Wanigasekera, Vishvarani
    Vase, Lene
    Kelley, John M
    Kirsch, Irving
    Show allShow less

    Date
    2020-10-19
    Journal
    Psychotherapy and Psychosomatics
    Publisher
    S. Karger AG
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1159/000510738
    Abstract
    Introduction: Clinical and laboratory studies demonstrate that placebo and nocebo effects influence various symptoms and conditions after the administration of both inert and active treatments. Objective: There is an increasing need for up-to-date recommendations on how to inform patients about placebo and nocebo effects in clinical practice and train clinicians how to disclose this information. Methods: Based on previous clinical recommendations concerning placebo and nocebo effects, a 3-step, invitation-only Delphi study was conducted among an interdisciplinary group of internationally recognized experts. The study consisted of open- and closed-ended survey questions followed by a final expert meeting. The surveys were subdivided into 3 parts: (1) informing patients about placebo effects, (2) informing patients about nocebo effects, and (3) training clinicians how to communicate this information to the patients. Results: There was consensus that communicating general information about placebo and nocebo effects to patients (e.g., explaining their role in treatment) could be beneficial, but that such information needs to be adjusted to match the specific clinical context (e.g., condition and treatment). Experts also agreed that training clinicians to communicate about placebo and nocebo effects should be a regular and integrated part of medical education that makes use of multiple formats, including face-to-face and online modalities. Conclusions: The current 3-step Delphi study provides consensus-based recommendations and practical considerations for disclosures about placebo and nocebo effects in clinical practice. Future research is needed on how to optimally tailor information to specific clinical conditions and patients' needs, and on developing standardized disclosure training modules for clinicians.
    Rights/Terms
    © 2020 The Author(s) Published by S. Karger AG, Basel.
    Keyword
    Disclosure
    Expert consensus
    Nocebo effects
    Patient-clinician communication
    Placebo effects
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/14018
    ae974a485f413a2113503eed53cd6c53
    10.1159/000510738
    Scopus Count
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