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The placebo and nocebo phenomena : their clinical management and impact on treatment outcomes

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dc.contributor.authorChavarria, Victor
dc.contributor.authorVian, João
dc.contributor.authorPereira, Círia
dc.contributor.authorData-Franco, João
dc.contributor.authorFernandes, Brisa S.
dc.contributor.authorBerk, Michael
dc.contributor.authorDodd, Seetal
dc.date.accessioned2020-11-12T13:16:07Z
dc.date.available2020-11-12T13:16:07Z
dc.date.issued2017
dc.description© 2017 Elsevier HS Journals, Inc. All rights reservedpt_PT
dc.description.abstractPurpose: 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. Methods: A narrative literature search of PubMed was conducted (January 1980-September 2016). Systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on placebo or nocebo effects in clinical practice were included in the qualitative synthesis. Search terms included: placebo, nocebo, clinical, clinical trial, clinical setting, placebo effect, nocebo effect, adverse effects, and treatment outcomes. This search was augmented by a manual search of the references of the key articles and the related literature. Findings: Placebo and nocebo effects are psychobiological events imputable to the therapeutic context. Placebo is defined as an inert substance that provokes perceived benefits, whereas the term nocebo is used when an inert substance causes perceived harm. Their major mechanisms are expectancy and classical conditioning. Placebo is used in several fields of medicine, as a diagnostic tool or to reduce drug dosage. Placebo/nocebo effects are difficult to disentangle from the natural course of illness or the actual effects of a new drug in a clinical trial. There are known strategies to enhance clinical results by manipulating expectations and conditioning. Implications: 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.pt_PT
dc.description.sponsorshipDr. Berk is supported by a National Health and Medical Research Council Senior Principal Research Fellowship (GNT1059660). All contributors to this manuscript are listed as co-authors. Michael Berk is supported by a NHMRC Senior Principal Research Fellowship (1059660). All authors were involved in all aspects of preparing this review paper, including the literature search and writingpt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationClin Ther. 2017 Mar;39(3):477-486pt_PT
dc.identifier.doi10.1016/j.clinthera.2017.01.031pt_PT
dc.identifier.issn0149-2918
dc.identifier.urihttp://hdl.handle.net/10451/44854
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttps://www.clinicaltherapeutics.com/pt_PT
dc.subjectAdverse effectspt_PT
dc.subjectClinical trialpt_PT
dc.subjectNocebopt_PT
dc.subjectPharmacologypt_PT
dc.subjectPlacebopt_PT
dc.subjectTreatment.pt_PT
dc.titleThe placebo and nocebo phenomena : their clinical management and impact on treatment outcomespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage486pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage477pt_PT
oaire.citation.titleClinical Therapeuticspt_PT
oaire.citation.volume39pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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