A test of positive suggestions about side effects as a way of enhancing the analgesic response to NSAIDs.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_9C83B2E26FB8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A test of positive suggestions about side effects as a way of enhancing the analgesic response to NSAIDs.
Journal
PloS one
Author(s)
Fernandez A., Kirsch I., Noël L., Rodondi P.Y., Kaptchuk T.J., Suter M.R., Décosterd I., Berna C.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2019
Peer-reviewed
Oui
Volume
14
Number
1
Pages
e0209851
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Side effects are frequent in pharmacological pain management, potentially preceding analgesia and limiting drug tolerability. Discussing side effects is part of informed consent, yet can favor nocebo effects. This study aimed to test whether a positive suggestion regarding side effects, which could act as reminders of the medication having been absorbed, might favor analgesia in a clinical interaction model. Sixty-six healthy males participated in a study "to validate pupillometry as an objective measure of analgesia". Participants were unknowingly randomized double-blind to positive vs control information about side effects embedded in a video regarding the study drugs. Sequences of moderately painful heat stimuli applied before and after treatment with diclofenac and atropine served to evaluate analgesia. Atropine was deceptively presented as a co-analgesic, but used to induce side effects. Adverse events (AE) were collected with the General Assessment of Side Effects (GASE) questionnaire prior to the second induced pain sequence. Debriefing fully informed participants regarding the purpose of the study and showed them the two videos.The combination of medication led to significant analgesia, without a between-group difference. Positive information about side effects increased the attribution of AE to the treatment compared to the control information. The total GASE score was correlated with analgesia, i.e., the more AEs reported, the stronger the analgesia. Interestingly, there was a significant between-groups difference on this correlation: the GASE score and analgesia correlated only in the positive information group. This provides evidence for a selective link between AEs and pain relief in the group who received the suggestion that AEs could be taken as a sign "that help was on the way". During debriefing, 65% of participants said they would prefer to receive the positive message in a clinical context. Although the present results cannot be translated immediately to clinical pain conditions, they do indicate the importance of testing this type of modulation in a clinical context.
Pubmed
Web of science
Open Access
Yes
Create date
20/01/2019 16:10
Last modification date
20/08/2019 16:03
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