Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?

@article{Kaptchuk2018OpenLP,
  title={Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits?},
  author={Ted J. Kaptchuk and Franklin G. Miller},
  journal={British Medical Journal},
  year={2018},
  volume={363}
}
Results from small clinical trials suggesting that placebos can be ethically and effectively used in clinical practice warrant further study, argue Ted Kaptchuk and Franklin Miller 

Clinical Use of Placebos

Deliberate use of placebos is usually considered unethical and may undermine trust, compromise the patient–physician relationship, and result in medical harm to the patient.

Placebos in clinical care: a suggestion beyond the evidence

The clinical use of placebos is often justified by pointing to their important treatment effects, but the evidence underpinning these claims is considered.

The Dangerous Side of Placebo Research: Is Hard Science Boosting Pseudoscience?

  • F. Benedetti
  • Medicine
    Clinical pharmacology and therapeutics
  • 2019
The progress of placebo research over the past years has benefited all medical sciences, but this new scientific knowledge is now backfiring on it, and some dangers need to be addressed, particularly in clinical practice, where the inappropriate use of placebos can harm.

Conditioning open-label placebo: a pilot pharmacobehavioral approach for opioid dose reduction and pain control

Given the complexity of pain management in rehabilitation settings, pharmaco-behavioral interventions can capitalize on the self-modulatory process to enhance the effects of a drug-based intervention.

Enthusiastic claims for open-label placebo pills ignore the evidence.

The notion that open-label placebos will provide clinically important effects on low back pain seems a vain hope that is inconsistent with the broader research in this field and the actual effects reported in open- label trials.

A discursive exploration of public perspectives on placebos and their effects

A discourse analysis of internet comments on news articles related to placebos aims to improve knowledge of public perspectives on placebos for clinicians and researchers, and developed two discursive constructs of the placebo.

Open-label placebo clinical trials: is it the rationale, the interaction or the pill?

It is concluded that there may yet be potential to use OLPs in medical practice but clinical translation depends on rigorously controlled research.

Physician perspectives on placebo ethics

It was found that while the non-transparency and deceptiveness of offering non-disclosed placebos was a concern for some physicians, their primary focus when considering both non- Disclosed and OLPs was identifying and weighing potential harms and benefits to patients.

The role of placebos in family medicine: Implications of evidence and ethics for general practitioners.

  • C. Blease
  • Medicine
    Australian journal of general practice
  • 2019
Evaluating the latest research into 'open-label placebos', it can be surmised that there are not yet persuasive grounds to incorporate these treatments into routine clinical care, but the quality of physician interactions may go some way to harnessing remedial placebo effects among patients.

Open-Label Placebo Treatment: Outcome Expectations and General Acceptance in the Lay Population

Surprisingly, the application of DPs was rated as more acceptable than OLPs, and this result might be explained by indirect effects of treatment expectations.
...

References

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Research has revealed placebo effects to be genuine biopsychosocial phenomena representing more than simply spontaneous remission or normal symptom fluctuations. How can this understanding be used to

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An innovative multidisciplinary trial design that attempts to replicate and expand upon an earlier IBS OLP study by comparing, for the first time, OLP and DBP administration and explores genetic, psychological and experiential dimensions of OLP.

Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome

Whether open-label placebo is superior to a no-treatment control with matched patient-provider interactions in the treatment of irritable bowel syndrome (IBS) is tested and placebos administered without deception may be an effective treatment for IBS.

Open-Label Placebo: Reflections on a Research Agenda

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The author discusses how OLP, mostly non-consciously, might perturb aberrant symptom amplifications and central sensitization resulting in perceptions of improvement in symptoms.

Why do open-label placebos work? A randomized controlled trial of an open-label placebo induction with and without extended information about the placebo effect in allergic rhinitis

Positive expectations do not contribute to the efficacy of open-label placebos, but seem to have an effect on more global and subjective well-being (mental or emotional quality of life).

Are Open‐Label Placebos Ethical? Informed Consent and Ethical Equivocations

It is found that open placebos may be said to involve equivocated over how placebos work, and it is suggested that this equivocation appears to be acceptable to patients.

When and Why Placebo-Prescribing Is Acceptable and Unacceptable: A Focus Group Study of Patients' Views

When and why placebo-prescribing in primary care might be acceptable and unacceptable to patients is identified and optimal ways of harnessing placebo effects in clinical practice are needed.

Components of Placebo Effect: Randomised Controlled Trial in Patients with Irritable Bowel Syndrome

Whether placebo effects can experimentally be separated into the response to three components—assessment and observation, a therapeutic ritual, and a supportive patient-practitioner relationship—and then progressively combined to produce incremental clinical improvement in patients with irritable bowel syndrome is investigated.