7 ways to prevent the nocebo effect

Emphasise the positive and play down the negative

Negative communication during treatment can significantly reduce the pharmacological effectiveness of pain medication, according to a growing body of evidence.

pain assessment balloons

Research shows that overemphasising negative side-effects can inadvertently induce a reaction similar to the nocebo effect.

The authors of a recent paper give seven tips for preventing this in pain therapy:

  1. Emphasise positive drug effects and avoid overemphasising adverse effects.
  2. Explain the mechanisms of drug action.
  3. Speak to the patient rather than just providing written material.
  4. Manage expectations. Research shows those with negative expectations have a worse outcome.
  5. Always tell the patient what they are taking. Unintentionally hiding information results in a significant lack of positive effects from the medication.
  6. Be aware that patients' emotional burden while undertaking pain management treatments can interfere with the intervention's positive effects.
  7. Treating pain adequately in early life as well as in non-communicative patients helps to avoid cued and contextual conditioning nocebo effects.

Read the full paper here