Monday, December 27, 2010

Open-Label Placebo Provides Therapeutic Benefit

Author: Brian Gabriel

Investigators recently compared an open-label placebo intervention to a no-treatment control for the treatment of irritable bowel syndrome (IBS) as detailed here. Surprisingly, investigators found the open-label placebo superior to the no-treatment control. Specifically, upon conclusion of the study, participants receiving the open-label placebo demonstrated statistically significant improvements in IBS symptoms over the no-treatment control group (as measured by several IBS scales).

Critically, all participants were coached as to the benefit of placebo pills throughout the study. For example, participants were told “placebo pills, something like sugar pills, have been shown in rigorous clinical testing to produce significant mind-body self-healing processes.” Additional coaching by clinical providers (either gastroenterologists or nurse-practitioners) expounded the benefit of placebo pills with statements such as “the body can automatically respond to placebo pills,” and “the placebo effect is powerful.”

Some may surmise that the therapeutic effect may be largely attributed to the influence of clinical authorities conducting the study. However, interestingly, there was no statistically significant difference in treatment response for participants coached and assessed by nurse practitioners versus physicians.
The authors conclude that utilizing placebos with coaching may be warranted, especially as part of a “wait and watch” approach. Further studies may be warranted investigating the influence of open placebos plus coaching in other illnesses (particularly illnesses measured in subjective terms such as depression, anxiety, and chronic pain).

This was written by Brian Gabriel.

Brian is a budding medical writer with a background in medicine and psychology. As an undergraduate studying at Muhlenberg College, Brian pursued a writing and research-intensive psychology and pre-medical curriculum. At Muhlenberg, Brian joined several honors societies including the Phi Beta Kappa Society. As a medical student at Jefferson Medical College, Brian passed both Steps I and II of the USMLE before leaving school to be with his terminally ill father. Brian looks forward to recontributing to the field of medicine as a medical writer. In his free time, Brian enjoys meditating, exercising, and volunteering.

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