Cargando…

What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care

A placebo effect is a positive clinical response to non-specific elements of treatment with a sham or inert replica of a drug, device, or surgical intervention. There is considerable evidence that placebo effects are driven by expectation of benefit from the intervention. Expectation is shaped by a...

Descripción completa

Detalles Bibliográficos
Autores principales: Yetman, Hailey E., Cox, Nevada, Adler, Shelley R., Hall, Kathryn T., Stone, Valerie E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733207/
https://www.ncbi.nlm.nih.gov/pubmed/35002881
http://dx.doi.org/10.3389/fpsyg.2021.788230
_version_ 1784627750484574208
author Yetman, Hailey E.
Cox, Nevada
Adler, Shelley R.
Hall, Kathryn T.
Stone, Valerie E.
author_facet Yetman, Hailey E.
Cox, Nevada
Adler, Shelley R.
Hall, Kathryn T.
Stone, Valerie E.
author_sort Yetman, Hailey E.
collection PubMed
description A placebo effect is a positive clinical response to non-specific elements of treatment with a sham or inert replica of a drug, device, or surgical intervention. There is considerable evidence that placebo effects are driven by expectation of benefit from the intervention. Expectation is shaped by a patient’s past experience, observations of the experience of others, and written, verbal, or non-verbal information communicated during treatment. Not surprisingly, expectation in the clinical setting is strongly influenced by the attitude, affect, and communication style of the healthcare provider. While positive expectations can produce beneficial effects, negative information and experiences can lead to negative expectations, and consequently negative or nocebo effects. Key components identified and studied in the placebo and nocebo literature intersect with factors identified as barriers to quality care in the clinical setting for Black patients and other patients of color, including poor patient-clinician communication, medical mistrust, and perceived discrimination. Thus, in the context of discrimination and bias, the absence of placebo and presence of nocebo-generating influences in clinical settings could potentially reinforce racial and ethnic inequities in clinical outcomes and care. Healthcare inequities have consequences that ripple through the medical system, strengthening adverse short- and long-term outcomes. Here, we examine the potential for the presence of nocebo effects and absence of placebo effects to play a role in contributing to negative outcomes related to unequal treatment in the clinical encounter.
format Online
Article
Text
id pubmed-8733207
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-87332072022-01-07 What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care Yetman, Hailey E. Cox, Nevada Adler, Shelley R. Hall, Kathryn T. Stone, Valerie E. Front Psychol Psychology A placebo effect is a positive clinical response to non-specific elements of treatment with a sham or inert replica of a drug, device, or surgical intervention. There is considerable evidence that placebo effects are driven by expectation of benefit from the intervention. Expectation is shaped by a patient’s past experience, observations of the experience of others, and written, verbal, or non-verbal information communicated during treatment. Not surprisingly, expectation in the clinical setting is strongly influenced by the attitude, affect, and communication style of the healthcare provider. While positive expectations can produce beneficial effects, negative information and experiences can lead to negative expectations, and consequently negative or nocebo effects. Key components identified and studied in the placebo and nocebo literature intersect with factors identified as barriers to quality care in the clinical setting for Black patients and other patients of color, including poor patient-clinician communication, medical mistrust, and perceived discrimination. Thus, in the context of discrimination and bias, the absence of placebo and presence of nocebo-generating influences in clinical settings could potentially reinforce racial and ethnic inequities in clinical outcomes and care. Healthcare inequities have consequences that ripple through the medical system, strengthening adverse short- and long-term outcomes. Here, we examine the potential for the presence of nocebo effects and absence of placebo effects to play a role in contributing to negative outcomes related to unequal treatment in the clinical encounter. Frontiers Media S.A. 2021-12-23 /pmc/articles/PMC8733207/ /pubmed/35002881 http://dx.doi.org/10.3389/fpsyg.2021.788230 Text en Copyright © 2021 Yetman, Cox, Adler, Hall and Stone. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Yetman, Hailey E.
Cox, Nevada
Adler, Shelley R.
Hall, Kathryn T.
Stone, Valerie E.
What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care
title What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care
title_full What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care
title_fullStr What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care
title_full_unstemmed What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care
title_short What Do Placebo and Nocebo Effects Have to Do With Health Equity? The Hidden Toll of Nocebo Effects on Racial and Ethnic Minority Patients in Clinical Care
title_sort what do placebo and nocebo effects have to do with health equity? the hidden toll of nocebo effects on racial and ethnic minority patients in clinical care
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733207/
https://www.ncbi.nlm.nih.gov/pubmed/35002881
http://dx.doi.org/10.3389/fpsyg.2021.788230
work_keys_str_mv AT yetmanhaileye whatdoplaceboandnoceboeffectshavetodowithhealthequitythehiddentollofnoceboeffectsonracialandethnicminoritypatientsinclinicalcare
AT coxnevada whatdoplaceboandnoceboeffectshavetodowithhealthequitythehiddentollofnoceboeffectsonracialandethnicminoritypatientsinclinicalcare
AT adlershelleyr whatdoplaceboandnoceboeffectshavetodowithhealthequitythehiddentollofnoceboeffectsonracialandethnicminoritypatientsinclinicalcare
AT hallkathrynt whatdoplaceboandnoceboeffectshavetodowithhealthequitythehiddentollofnoceboeffectsonracialandethnicminoritypatientsinclinicalcare
AT stonevaleriee whatdoplaceboandnoceboeffectshavetodowithhealthequitythehiddentollofnoceboeffectsonracialandethnicminoritypatientsinclinicalcare