Nocebo and Informed Consent in the Internet Era

Meynen, Gerben; Swaab, Dick F.; Widdershoven, Guy

doi:10.1080/15265161.2011.652801

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…However, such strategies have yet to be empirically tested, and concerns have been raised about whether this approach undermines informed consent (Miller, ). In addition, the availability of health information on the internet means that those who feel they have not received adequate treatment information may simply “Google it” (Meynen, Swaab, & Widdershoven, ).…”

Section: Evidence‐based Strategies For Reducing Nocebo Effectsmentioning

confidence: 99%

Nocebo effects in health psychology

Faasse

2019

Australian Psychologist

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The nocebo effect is a potentially powerful phenomenon that can result in harmful or unpleasant treatment outcomes caused by negative expectations, past experience, and other aspects of the treatment context. These aversive outcomes can cause patients to discontinue an otherwise beneficial treatment-resulting in suboptimal health outcomes, added burden of illness, reduced quality of life, and unnecessary hospitalisations, medical consultations, and increased cost for both the patient and the health care system. Much research to date has focused on the role of negative expectations in nocebo effects; this review also emphasises the more overlooked mechanisms of anxiety and classical conditioning, and how these might be usefully targeted to reduce nocebo effects. The evidence for each of these mechanisms, and their potential interactions, is reviewed. Regardless of how they develop, nocebo effects can contribute substantially to the overall burden of treatment side effects, and an overview of evidence-based interventions to reduce nocebo effects by targeting each of the underlying mechanisms is presented. Currently, no strategies are systematically applied to reduce nocebo effects, and most interventions have yet to be translated from experimental laboratory research into applied clinical settings. Future work should focus on developing and testing theoretically-based interventions to reduce nocebo effects, and on translating findings from lab-based studies into clinical practice and healthcare policy. K E Y W O R D S anxiety, classical conditioning, negative expectations, nocebo, side effects

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Section: Evidence‐based Strategies For Reducing Nocebo Effectsmentioning

confidence: 99%

Nocebo effects in health psychology

Faasse

2019

Australian Psychologist

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“…Many patients seek out information about treatment side effects online (Meynen et al . ) and Mitsikostas et al . (, p. 559) note that accessing online information, particularly about drug safety ‘without proper re‐assurance from their physician may increase nocebo’.…”

Section: Introductionmentioning

confidence: 85%

Nocebo and the potential harm of ‘high risk’ labelling: a scoping review

Symon¹,

Williams

Adelasoye

et al. 2015

Journal of Advanced Nursing

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While the placebo effect is well documented, there has been no systematic attempt to synthesize primary empirical research on the role of nocebo. It is possible that nocebo outcomes may be preventable through careful consideration of information provision and the prior identification of potentially high risk individuals. This paper summarizes the scale and importance of the nocebo effect, its distribution according to a range of social and clinical variables and its known relation to psychological precursors. It identifies important gaps in the research literature.

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“…Nocebo responses are contextualised, potentially learnt or conditioned, and are dependent on negative expectation setting. Providing an exhaustive inventory of potential adverse effects in a context irrelevant to the patient, while fulfilling the duty of truth telling, may not serve patients' best interests as ‘mere information about potential harm is likely to be harmful in itself’ . Importantly, information about therapies is not simply provided by medical practitioners but is increasingly gained from different sources including friends, relatives, support groups and all forms of media.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, information about therapies is not simply provided by medical practitioners but is increasingly gained from different sources including friends, relatives, support groups and all forms of media. The Internet, for example, can be an important source of positive and negative information, and the patient may have already developed clear expectations about a treatment on the basis of their prior enquiries.…”

Section: Discussionmentioning

confidence: 99%

“…Given the existence and influence of a pervasive societal dialogue of risk that affects one's ontological security, information regarding treatments derived from sources other than the practitioner must be appreciated and acknowledged, but ultimately, the notion of contextualised consent should consider how much information a patient wishes to receive, recognising that this is an iterative process, with a compromise between unfettered patient autonomy and unjustified paternalism …”

Section: Discussionmentioning

confidence: 99%

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Medicine's inconvenient truth: the placebo and nocebo effect

Arnold

Finniss

Kerridge

2014

Internal Medicine Journal

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Placebo and nocebo effects are often regarded by clinicians as either a quaint reminiscence from the pre-therapeutic era, or simply as a technique for establishing the efficacy of therapeutic interventions within the locus of evidence-based practice. However, neither of these explanations sufficiently account for their complexity or their persistence and impact in clinical medicine. Placebo and nocebo effects are embedded in the very fabric of therapeutic relationships and are both a manifestation and outcome of the rituals that characterise clinical practice. They are also a stark reminder of the many personal and environmental factors, including the attitudes, beliefs and expectations of both doctor and patient, that shape the outcomes of health professional-patient interactions. We describe how recent biological and neuropsychiatric data have clarified the operation of placebo and nocebo effects in clinical practice - demonstrating the ability of the therapeutic context to modulate endogenous biological processes in a targeted manner. This, in turn, illustrates the potent philosophical and sociocultural aspects of medical praxis.

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Nocebo and Informed Consent in the Internet Era

Cited by 7 publications

References 10 publications

Nocebo effects in health psychology

Nocebo effects in health psychology

Nocebo and the potential harm of ‘high risk’ labelling: a scoping review

Medicine's inconvenient truth: the placebo and nocebo effect

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