What Should Clinicians Tell Patients about Placebo and Nocebo Effects? Practical Considerations Based on Expert Consensus
Author
Evers, Andrea W MColloca, 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
Date
2020-10-19Journal
Psychotherapy and PsychosomaticsPublisher
S. Karger AGType
Article
Metadata
Show full item recordAbstract
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.Identifier to cite or link to this item
http://hdl.handle.net/10713/14018ae974a485f413a2113503eed53cd6c53
10.1159/000510738