The University of Southampton
Psychology

Research project: Creating a taxonomy to harness the placebo effect in UK primary care

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The placebo effect can exert a powerful influence on common symptoms including pain, low mood, digestive symptoms, and insomnia. Recently, experts have called for more research that tries to take the findings from laboratory studies of placebos and apply them in real world clinical settings to improve the effectiveness and cost-effectiveness of health care. One way of doing this would be to consider having GPs prescribe placebos. Other, probably more acceptable, approaches include learning lessons from the published work on placebos about how to manage patients’ expectations of treatments so as to maximise therapeutic effectiveness (as the overall effectiveness of most treatments consists of both the effect of the intervention itself and the effect of the meaning that the patient ascribes to the intervention).

Project Overview

The placebo effect can exert a powerful influence on common symptoms including pain, low mood, digestive symptoms, and insomnia. Recently, experts have called for more research that tries to take the findings from laboratory studies of placebos and apply them in real world clinical settings to improve the effectiveness and cost-effectiveness of health care. One way of doing this would be to consider having GPs prescribe placebos. Other, probably more acceptable, approaches include learning lessons from the published work on placebos about how to manage patients’ expectations of treatments so as to maximise therapeutic effectiveness (as the overall effectiveness of most treatments consists of both the effect of the intervention itself and the effect of the meaning that the patient ascribes to the intervention).

In this project, we are working to create a novel and comprehensive taxonomy of the different techniques that could be used to harness the placebo effect in primary care. This will make a vital contribution to a future collaborative programme of work that will include a clinical trial to test the effectiveness and cost-effectiveness of placebo-based interventions. Because this is a new and controversial area for research it is important to carry out careful and thorough developing work before embarking on such a trial. In particular, we are sensitive to the ethical controversies around the idea of using placebo effects in clinical practice and the need for any intervention to be acceptable to patients and clinicians.

In this project, we are developing a taxonomy of different ways in which we could harness the placebo effect based on a review of existing studies in clinical and laboratory settings. We will incorporate patients’ and clinicians’ views into the taxonomy, by convening a series of structured group discussions and eliciting participants’ views. We will also incorporate the views of other experts (ethicists, leading primary care and placebo researchers) by carrying out a survey to ascertain their views as to the feasibility and plausibility of each technique. Thus at the end of this project we will deliver an original comprehensive taxonomy of techniques to elicit placebo effects, that incorporates the views of three key stakeholder groups – patients, clinicians, and researchers. We will publish this taxonomy so that others can build on and use our work. In the future we plan to work with collaborators and use our taxonomy to develop a new complex intervention that is acceptable to patients and clinicians, is theoretically plausible, and which we can test to see if it is an effective means of harnessing placebo effects in primary care.

Funding: NIHR School for Primary Care Research (£45,179)

Related research groups

Primary Care & Population Sciences Academic Units

Staff

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