Tag Archives: Medicine

‘CONVERSATION’ AND THE PLACEBO EFFECT

From the earliest days of placebo research the practitioner-patient relationship has been at the heart of theorising about its effectiveness in therapy (and in life!)

Here’s an article that explores ‘the conversation’ and its beneficial placebo effects.

” … it’s no surprise that chronic arthritis and back pain are the second and third most common non-acute reasons that people go to the doctor and that pain costs America up to $635 billion annually. The pain remedies developed by the pharmaceutical industry are only modestly effective, and they have side effects that range from nausea and constipation to addiction and death.

What’s often overlooked is that the simple conversation between doctor and patient can be as potent an analgesic as many treatments we prescribe.”

… and …

“It’s clear that how doctors and nurses communicate their treatment can have profound effects on how patients experience the results of that treatment. Yet the conversation between doctors and patients is one of the least valued aspects of medical care. Insurance reimbursements for tests and medical procedures dwarf reimbursements for talking to patients or spending time thinking about what ails them. And the pharmaceutical industry, with its direct-to-consumer advertising, has promulgated the fallacy that every ailment must be met with a pill — brand name, of course.”

Is acupuncture a placebo?

In a report published in the National Institute for Health Research (NIHR) Journals Library, the researchers showed that there is significant evidence to demonstrate that acupuncture provides more than a placebo effect.

Professor of Acupuncture Research, Hugh MacPherson, working with a team of scientists from the UK and US, brought together the results of 29 high quality clinical trials focused on patients treated with acupuncture and standard medical care.

In the majority of these trials, patients with chronic pain treated with acupuncture and standard medical care were tested against those who were provided with standard medical care alone, such as anti-inflammatory drugs and physiotherapy. The trials involved approximately 18,000 patients diagnosed with chronic pain of the neck, lower back, head, and knee.

The report shows that the addition of acupuncture compared to standard medical care alone significantly reduced the number of headaches and migraine attacks and reduced the severity of neck and lower back pain. It also showed that acupuncture reduced the pain and disability of osteoarthritis, which led to patients being less reliant on anti-inflammatory tablets to control pain.

Read the full article here.

Broken heart? You need a placebo!

All over the interwebs right now!

Researchers at the University of Colorado-Boulder studied 40 recently jilted volunteers and found they displayed less physical pain and felt better emotionally — even after receiving a fake drug.

“Breaking up with a partner is one of the most emotionally negative experiences a person can have, and it can be an important trigger for developing psychological problems,” said the study’s lead author, Dr. Leonie Koban.

“In our study, we found a placebo can have quite strong effects on reducing the intensity of social pain,” she said.

Among the myriad stories covering this, check out the New York Daily News, MedicalExpress, and Science Daily.

‘Psychological Interventions’

A recent meta-study in the World Journal of Gastroenterology (March 28 2017) – Systematic review: The placebo effect of psychological interventions in the treatment of irritable bowel syndrome

Aim – “To determine the placebo response rate associated with different types of placebo interventions used in psychological intervention studies for irritable bowel syndrome.” (Six studies, with a total of 555 patients met the inclusion criteria.)

… and the placebo effect, unsurprisingly, figures significantly:

“Contrary to our expectations, the PRR (Placebo Response Rate) in studies on psychological interventions was comparable to that in studies on pharmacological, dietary and alternative medical interventions.”

Download the whole study in PDF here.

When you know you’re taking a placebo …

This question/comment/assumption comes up a lot when we talk to people about placebos and the placebo effect. ‘It works’ (is the assumption) ‘if people believe it’s something else’ …

Like the ‘real’ thing, perhaps …? We’ve posted on this before, and it seems the research is becoming more robust and rigorous.

Once more, courtesy of Professor Kaptchuk … read Knowingly Taking a Placebo Still Reduces Pain, Studies Find …

Arthritis medication: placebo beats supplements

Many people take glucosamine and chondroitin supplements for arthritis pain, but a controlled trial has found no evidence that the combination works. In fact, in this study, the placebo worked better.

Spanish researchers randomized 164 men and women with knee osteoarthritis to take a single daily dose of 1,500 milligrams of glucosamine and 1,200 of chondroitin, or an identical looking placebo. The study is in Arthritis & Rheumatology.

Read the full article here.

 

Placebo Effect Works for Heart Procedures, Too

New research has shown that patient’s envisioning and expecting positive results from major surgery, including open heart surgery, will over time actually recover and heal more effectively.

“Optimizing patients’ expectations pre-surgery helps to improve outcome 6 months after treatment. This implies that making use of placebo mechanisms has the potential to improve long-term outcome of highly invasive medical interventions”

On Placebos and Depression Drugs

We note an interesting ‘counter narrative’ emerging – that is, scepticism about the commonly held view that drug treatments designed for mood disorders such as depression often engage the Placebo Effect. In this counter-narrative,

“Drug trials don’t show much in the way of classic placebo effects. The rise in placebo responses over the years is more likely due to the supportive factors in drug trials…and increasing problems with enrollment.”

The new finding—no upward trend in placebo responses—is unexpected and certain to be contested. Meanwhile, it stands as a rebuke to a popular narrative. By that account, drug effects had been hyped, expectations soared, and the inflated hopes were reflected in rising placebo response rates.”

This is fine, except the counter-narrative also resonates with challenges about the efficacy of conventional ‘gold-standard’ ‘blind’ ‘placebo controlled’ drug trials, where it has been shown that trials funded by drug companies (who by definition have a vested interest in their outcome) are 30% more likely to return ‘favourable’ results than trials which are not funded in this way. The ‘placebo effect’ might be the design and execution of the trial itself, not the actual function and efficacy of the placebo …!

Read the whole article here.

Taking placebo pills may ease chronic back pain

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Quite a buzz lately about the placebo effect and back pain, extending from a randomized control trial in Portugal.

“Our findings demonstrate the placebo effect can be elicited without deception. Patients were interested in what would happen and enjoyed this novel approach to their pain. They felt empowered.” – Lead author Claudia Carvalho, Ph.D., ISPA

“It’s the benefit of being immersed in treatment: interacting with a physician or nurse, taking pills, all the rituals and symbols of our healthcare system,” (says placebo researcher Ted Kaptchuk, Professor of Medicine at Harvard Medical School). “The body responds to that.”

While this study focused on chronic pain, Kaptchuk says it is possible that patients with other conditions that involve self-observation – such as fatigue, depression, or digestive problems – may benefit from open-label placebo treatment.

“You’re never going to shrink a tumor or unclog an artery with placebo intervention,” notes Kaptchuk. “It’s not a cure-all, but it makes people feel better, for sure. Our lab is saying you can’t throw the placebo into the trash can. It has clinical meaning, it’s statically significant, and it relieves patients. It’s essential to what medicine means.”

Read the whole article here, and another here.