• EversAndrea W MAWMHealth, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands, a.evers@fsw.leidenuniv.nl.Erasmus University Rotterdam & Delft University of Technology, Rotterdam/Delft, The Netherlands, a.e, Luana Colloca, Charlotte Blease, Jens Gaab, Karin B Jensen, Lauren Y Atlas, Chris J Beedie, Fabrizio Benedetti, Ulrike Bingel, Christian Büchel, Jet Bussemaker, Ben Colagiuri, Alia J Crum, Damien G Finniss, Andrew L Geers, Jeremy Howick, Regine Klinger, Stefanie H Meeuwis, Karin Meissner, Vitaly Napadow, Keith J Petrie, Winfried Rief, Ionica Smeets, Tor D Wager, Vishvarani Wanigasekera, Lene Vase, John M Kelley, Irving Kirsch, and Consortium of Placebo Experts.
• Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands, a.evers@fsw.leidenuniv.nl.
• Psychother Psychosom. 2021 Jan 1; 90 (1): 49-56.

IntroductionClinical and laboratory studies demonstrate that placebo and nocebo effects influence various symptoms and conditions after the administration of both inert and active treatments.ObjectiveThere 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.MethodsBased 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.ResultsThere 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.ConclusionsThe 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.© 2020 The Author(s) Published by S. Karger AG, Basel.

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