Clinical therapeutics
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Clinical therapeutics · Mar 2017
ReviewThe Placebo and Nocebo Phenomena: Their Clinical Management and Impact on Treatment Outcomes.
This overview focuses on placebo and nocebo effects in clinical trials and routine care. Our goal was to propose strategies to improve outcomes in clinical practice, maximizing placebo effects and reducing nocebo effects, as well as managing these phenomena in clinical trials. ⋯ Placebo and nocebo effects occur frequently and are clinically significant but are underrecognized in clinical practice. Physicians should be able to recognize these phenomena and master tactics on how to manage these effects to enhance the quality of clinical practice.
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Clinical therapeutics · Mar 2017
ReviewA Review of the Theoretical and Biological Understanding of the Nocebo and Placebo Phenomena.
Placebos are commonly used in experimental and patient populations and are known to influence treatment outcomes. The mechanism of action of placebos has been investigated by several researchers. This review investigates the current knowledge regarding the theoretical and biological underpinning of the nocebo and placebo phenomena. ⋯ Further research is needed to fully understand the underpinnings of the nocebo and placebo phenomena. Neurobiology pathways need to be investigated in experimental paradigms that model the placebo response to a broader range of pathologies. Similarly, although many psychological factors and inter-individual characteristics have been identified as significant mediators and moderators of nocebo and placebo responses, the factors identified to date are unlikely to be exhaustive.
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Clinical therapeutics · Mar 2017
ReviewUnsolved, Forgotten, and Ignored Features of the Placebo Response in Medicine.
We aimed to identify topics of research that have been neglected, undervalued, or overseen in the past 2 decades of placebo/nocebo research. ⋯ The biggest threat for placebo research is that it may outdate itself by declaring all and everything as a placebo effect even if there may be better terms and concepts (eg, patient expectations, doctor-patient communication, empathy), and by ignoring that medicine continuously changes its face, for patients as well as for clinical researchers. Its biggest opportunity is the fact that it, as no other topic in medicine, requires both medical and psychological experts for its exploration and to stay updated.