Treating Pain With Open-Label Placebos: A Qualitative Study With Post-Surgical Pain Patients

被引:4
作者
Bernstein, Michael H. [1 ]
Fuchs, Nathaniel [1 ]
Rosenfield, Maayan [1 ]
Weiss, Arnold-Peter [2 ,3 ]
Blease, Charlotte [4 ,5 ]
Locher, Cosima [6 ,7 ]
Magill, Molly [1 ]
Rich, Josiah [8 ,9 ]
Beaudoin, Francesca L. [10 ,11 ,12 ,13 ]
机构
[1] Brown Univ, Ctr Alcohol & Addict Studies, Dept Behav & Social Sci, Sch Publ Hlth, 121 South Main St, Providence, RI 02912 USA
[2] Univ Orthoped Inc, East Providence, RI USA
[3] Brown Univ, Warren Alpert Med Sch, Div Hand Surg, Dept Orthopaed, Providence, RI 02912 USA
[4] Beth Israel Deaconess Med Ctr, Gen Med & Primary Care, Boston, MA 02215 USA
[5] Harvard Med Sch, Boston, MA 02115 USA
[6] Univ Hosp Zurich, Dept Consultat Liaison Psychiat & Psychosomat Med, Zurich, Switzerland
[7] Univ Basel, Fac Psychol, Div Clin Psychol & Psychotherapy, Basel, Switzerland
[8] Miriam Hosp, Providence, RI USA
[9] Brown Univ, Warren Alpert Med Sch, Providence, RI 02912 USA
[10] Brown Univ, Alpert Med Sch, Dept Emergency Med, Providence, RI 02912 USA
[11] Brown Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Serv, Providence, RI 02912 USA
[12] Brown Univ, Sch Publ Hlth, Dept Policy, Providence, RI 02912 USA
[13] Brown Univ, Sch Publ Hlth, Dept Practice, Providence, RI 02912 USA
基金
瑞士国家科学基金会;
关键词
Placebo; placebo effect; open-label placebo; acute pain; opioids;
D O I
10.1016/j.jpain.2021.05.001
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Prior research has shown that Open Label Placebos (OLPs; that is, placebos described honestly as inactive pills) are effective for a variety of clinical conditions, including pain. However, little is known about patient attitudes towards OLPs. We conducted qualitative interviews with n = 11 patients (73% female) who recently had hand or wrist surgery and took >= 1 opioid pill. Interview topics included: pain management, the placebo effect, and in particular, attitudes towards OLPs. Interviews were analyzed inductively and content-coded. Five themes were identified: 1) Role of the mind in pain and illness, 2) Shortcomings of opioids are the strengths of OLPs, 3) Perceptions of OLP effectiveness, 4) Relational aspects of OLP administration, and 5) Practical considerations for OLP implementation. Most patients agreed that, because of their transparency, OLPs are ethical. Partici-pants indicated some degree of reluctance about using OLPs, but the majority said they would take OLPs if prescribed by a doctor. Patients noted that the primary disadvantage of opioids is their potency, which can lead to addiction or side-effects; by contrast, the primary advantage of placebos is their inertness. Results suggest that OLPs appear to be well received as a postoperative pain treat-ment among the patients in this study. Perspective: This qualitative study examines how hand surgery patients view OLPs, which are placebos described honestly as inactive pills. OLPs were generally well received by patients as a treatment for pain after surgery and could be considered as an adjunctive treatment to potentially reduce reliance on prescription opioids. (C) 2021 by United States Association for the Study of Pain, Inc.
引用
收藏
页码:1518 / 1529
页数:12
相关论文
共 40 条
[1]   Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample [J].
Berman, AH ;
Bergman, H ;
Palmstierna, T ;
Schlyter, F .
EUROPEAN ADDICTION RESEARCH, 2005, 11 (01) :22-31
[2]   Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians [J].
Bernstein, Michael H. ;
Locher, Cosima ;
Stewart-Ferrer, Sif ;
Buergler, Sarah ;
DesRoches, Catherine M. ;
Dossett, Michelle L. ;
Miller, Franklin G. ;
Grose, Deborah ;
Blease, Charlotte R. .
BRITISH JOURNAL OF HEALTH PSYCHOLOGY, 2020, 25 (03) :596-614
[3]   Are Conditioned Open Placebos Feasible as an Adjunctive Treatment to Opioids? Results from a Single-Group Dose-Extender Pilot Study with Acute Pain Patients [J].
Bernstein, Michael H. ;
Magill, Molly ;
Weiss, Arnold-Peter ;
Kaptchuk, Ted J. ;
Blease, Charlotte ;
Kirsch, Irving ;
Rich, Josiah D. ;
Becker, Sara J. ;
Mach, Steven ;
Beaudoin, Francesca L. .
PSYCHOTHERAPY AND PSYCHOSOMATICS, 2019, 88 (06) :380-382
[4]   HARNESSING THE PLACEBO EFFECT: A PROMISING METHOD FOR CURBING THE OPIOID CRISIS? [J].
Bernstein, Michael H. ;
Magill, Molly ;
Beaudoin, Francesca L. ;
Becker, Sara J. ;
Rich, Josiah D. .
ADDICTION, 2018, 113 (11) :2144-2145
[5]   When and Why Placebo-Prescribing Is Acceptable and Unacceptable: A Focus Group Study of Patients' Views [J].
Bishop, Felicity L. ;
Aizlewood, Lizzi ;
Adams, Alison E. M. .
PLOS ONE, 2014, 9 (07)
[6]   Overcoming disagreement: a roadmap for placebo studies [J].
Blease, Charlotte ;
Annoni, Marco .
BIOLOGY & PHILOSOPHY, 2019, 34 (02)
[7]   The role of placebos in family medicine Implications of evidence and ethics for general practitioners [J].
Blease, Charlotte R. .
AUSTRALIAN JOURNAL OF GENERAL PRACTICE, 2019, 48 (10) :700-705
[8]   Open-label placebo clinical trials: is it the rationale, the interaction or the pill? [J].
Blease, Charlotte R. ;
Bernstein, Michael H. ;
Locher, Cosima .
BMJ EVIDENCE-BASED MEDICINE, 2020, 25 (05) :159-165
[9]  
Braun V., 2006, QUAL RES PSYCHOL, V3, P77, DOI DOI 10.1191/1478088706QP063OA
[10]   One size fits all? What counts as quality practice in (reflexive) thematic analysis? [J].
Braun, Virginia ;
Clarke, Victoria .
QUALITATIVE RESEARCH IN PSYCHOLOGY, 2021, 18 (03) :328-352