ArticlePloS one2019
A test of positive suggestions about side effects as a way of enhancing the analgesic response to NSAIDs.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Mitigating the Nocebo Effect in Biosimilar Use and Switching: A Systematic Review.Pharmaceutical medicine · 2024Pooled it
- Meta-analysis Comparing Celecoxib with Diclofenac Sodium in Patients with Knee Osteoarthritis.Pain medicine (Malden, Mass.) · 2021Pooled it
- Changing Mindsets About Side Effects of the COVID-19 Vaccination: A Randomized Controlled Trial.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2023Trial
- Changing mindsets about side effects.BMJ open · 2021Trial
- Effect of written outcome information on attitude of perinatal healthcare professionals at the limit of viability: a randomized study.BMC medical ethics · 2019Trial
- Leveraging expectation effects to improve outcomes in the context of digital mental health interventions.Internet interventions · 2026Review
- Observational
- Side-effects are often a curse. Can they also be a blessing?Brain : a journal of neurology · 2024Article
- Working with patients' treatment expectations - what we can learn from homeopathy.Frontiers in psychology · 2024Review
- Correlation of effectiveness and tolerability assessments from a pharmacy-based observational study investigating the fixed-dose combination of 400 mg ibuprofen plus 100 mg caffeine for the treatment of acute headache.Frontiers in neurology · 2023Article
- Avoidance of nocebo effects by coincident naming of treatment benefits during the medical interview for informed consent-Evidence from dynamometry.Frontiers in psychology · 2022Article
- The Unintended Consequences of Adverse Event Information on Medicines' Risks and Label Content.Pharmaceutical medicine · 2020Article
- Can Positive Framing Reduce Nocebo Side Effects? Current Evidence and Recommendation for Future Research.Frontiers in pharmacology · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.