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Placebo
pills without deception improved self reported outcomes such as disability and pain
in patients with chronic low back pain.
A recent study provides essential information on the power of placebo without deception, with acknowledgement of some methodological limitations. Interventions in placebo are becoming a robust method in randomized controlled trials challenging standard procedures and transforming improper procedures when no changes are observed in active and placebo responses. The placebo effect of an intervention is linked to a variety of factors like patient-clinician interactions, the expectation of improvement with management, and rituals other than the active ingredient of that intervention. These factors are also involved in the treatment approach. Introduction of placebo interventions in randomized controlled trials offers a potential advantage of blinding in assessors and patients. It appears to play an integral role in self-reported outcome measures such as pain and disability. Lack of blinding leads to significant overestimation of treatment benefits for self-reported measures. The recent research founded the effect of open-label placebo prescription in other fields, most likely due to the presentation of a real rationale, rather than deception, for the use of placebo as mentioned by the authors of this study.
A between-group difference in pain intensity of 1 point (0 to 10-point scale)
with a sample size of 96 participants was detected by this study that did not
account for the observed attrition rates (22%). Imprecise estimates of
treatment effects occurred when the between-group analyses were underpowered.
These between-group differences in pain scores also happen at baseline. This
study demonstrated the use of open-label placebos for enhancing objective
outcomes which seems to be integral for future studies. This study comes from
the first study to unveil the potential advantages of placebo interventions for
chronic low back pain. This study highlighted the impact of a favourable
treatment rationale and patient-clinician rapport in the management process.
Journal of Physiotherapy
Placebo pills provided without deception may help to reduce pain and disability in people with chronic low back pain [commentary]
Manuela L Ferreira et al.
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