Tag Archives: Research

The Nocebo Effect: the Placebo Effect Flipped!

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A nocebo is the opposite of placebo …

“The nocebo effect is the placebo effect’s less attractive younger sibling. While the placebo effect has the ability to help people feel better in the absence of any active ingredients, the nocebo effect has the ability to make a person feel poorly in the absence of any active stimuli …  a very real medical phenomenon.”

Further nocebo thoughts, related to people’s perception of harm from WiFi radiation, here.

So You Think You Know ‘Placebo’?

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It’s rare (but becoming more common) to find the placebo effect studied as a phenomenon in its own right. This carefully considered and researched article points to several perspectives …

1. There are two processes going on, the placebo and the placebo effect.
2. Placebo effects are not caused by the object (e.g. the pill) or the procedure (e.g. an injection)
3. Much of what is considered to be placebo improvement may actually be patient report of improvement, without any actual physical improvement.
4. The patient’s inaccurate perception of a successful treatment in the therapeutic environment is also influenced by:

The natural course of the disease
Concomitant treatments
The Hawthorne effect
Regression to the mean

5. The placebo effect is not “the power of positive thinking” or belief, hope, mind over matter or the mind healing the body

Does branding have a placebo effect?

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Image: James Merry

It seems that using an esteemed name-brand piece of sporting equipment actually generates stronger results.

“Our results indicate that strong performance brands can cause an effect that is akin to a placebo effect,” researcher Frank Germann of the Department of Marketing at the University of Notre Dame said in a press release. “Our results also suggest that the use of a strong performance brand causes participants to feel better about themselves when undertaking a task—that is, to have greater task-specific self-esteem. This higher self-esteem lowers their performance anxiety which, in turn, leads to the better performance outcomes.”

Read more here. And here.

Drug companies wine, dine and *educate* doctors about the drugs they prescribe

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If a drug company treats a doctor to a nice lunch and a presentation on their newest products, is prescribing affected? Doctors generally think not, but the research evidence overwhelmingly says yes. And if these events do affect doctors’ decisions on patient care, should we be worried?

Couldn’t they just prescribe placebos? Of course not! Where’s the profit in that?

GPs use placebos

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An interesting distinction  between ‘pure’ and impure’ placebos! (Universal Placebos are unapologetically PURE!)

“A pure placebo is a straightforwardly fake treatment – a saline injection or a sugar pill, for instance, that is represented as a drug.

An impure placebo is a substance or treatment that does have clinical value, but not for the condition for which it is being prescribed.

Impure placebos can be vitamins, nutritional supplements, antibiotics for viral infections, sub-clinical doses of drugs, unproven complementary and alternative medicines, or unnecessary blood tests to calm an anxious patient.”

A UK survey in 2012 showed that 1% of GPs use ‘pure’ placebos at least once a week, and an extraordinary 77% use ‘impure’ placebos at the same rate (though we suspect that’s often the habit of prescribing so-called ‘useless’ antibiotics for viral infections).

Legitimising alternatives!? No way! Well … maybe …

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“Britain’s Princess Alexandra Hospital NHS Trust wants to hire a reiki therapist for a hospital in Epping.”

This caused a controversy and a flurry of disgruntled email. BUT …

“If drugs are effective and placebo responses small, this does not matter much. But people tend to turn to alternative medicine for subjective, stress-related conditions such as chronic pain, depression, nausea and fatigue (all problems that can affect cancer patients in treatment). Drugs for these conditions have significant downsides, such as unpleasant side effects and addiction, and placebo responses often account for most of the effect of the drug. So it becomes plausible that compared to popping a pill, a patient might get more relief — and fewer side effects — from an hour with a sympathetic therapist.”