Placebo use in pain management: The role of medical context, treatment efficacy, and deception in determining placebo acceptability. Pain 2014 Dec;155(12):2638-2645
Date
10/01/2014Pubmed ID
25267208Pubmed Central ID
PMC4250369DOI
10.1016/j.pain.2014.09.029Scopus ID
2-s2.0-84922825155 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
Placebo effects can act as powerful pain relievers. Although the ethics of therapeutic placebo use are highly controversial, recent evidence suggests that medical providers frequently utilize placebo treatments and patients may be open to these interventions in certain contexts. This investigation used a patient-centered approach to answer essential questions about placebo treatment acceptability. People with chronic musculoskeletal pain completed a placebo survey in which they rated their knowledge of placebo and its efficacy for alleviating pain, evaluated the acceptability of placebo analgesic interventions across several unique medical contexts, and responded to 6 different patient-physician treatment scenarios to assess the role of deception and placebo effectiveness on mood and provider trust. Results showed that participants had limited knowledge of placebo and its efficacy for alleviating pain. Placebo acceptability was highly dependent on the context of the intervention, as placebo treatments were considered acceptable when used as complementary/adjunct treatments and when no other established treatments were available. Also, an analgesic placebo response mitigated the negative consequences of deception by improving provider trust and decreasing negative mood. These findings suggest that, contrary to popular belief, patients may be rather pragmatic in their appraisals of placebo treatment acceptability, and may consider a variety of treatments/contexts as ethically permissible for managing their pain. This is the first study of its kind to quantify perceptions of placebo analgesia knowledge and efficacy among individuals with chronic pain, and to assess the role of different medical contexts in treatment acceptability.
Author List
Kisaalita N, Staud R, Hurley R, Robinson MAuthor
Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Analgesics
Analysis of Variance
Deception
Female
Humans
Male
Middle Aged
Musculoskeletal Pain
Pain Management
Pain Measurement
Placebo Effect
Surveys and Questionnaires
Treatment Outcome
Trust
