Placebo and nocebo effect can arise anytime when people with (chronic) medical conditions encounter medical treatment. Healthcare provider-patient communication, prior experiences and expectations all affect medical treatment outcomes. Harnessing placebo effects in clinical encounters can therefore contribute to treatment in general, and strategies to reduce the risk of nocebo effects may also be employed.

Background

Placebo and nocebo effects contribute to medical treatment in everyday clinical practice, for instance through healthcare provider-patient interaction, patient’s expectations of treatment, and prior experiences with treatments. While healthcare providers frequently indicate that they use placebo effects or their mechanisms in clinical practice (Louhiala, 2012), formal training in this area is lacking so far. Ensuring that healthcare professionals know how to deal with placebo and nocebo effects in clinical practice is important for several reasons. For one, while placebo effects have the potential to contribute greatly to treatment outcomes, their use should be considered carefully as ethical concerns exist (e.g., Blease, 2012). In addition, there is a lack of awareness among healthcare providers about the existence of nocebo effects (Smits et al., 2022), and this needs to be addressed given that nocebo effects can affect wellbeing and disease courses adversely, and may even result in nonadherence, treatment discontinuation.

Methods

PANACEA is an interdisciplinary and international programme aimed to improve and standardize the education on placebo and nocebo effects across Europe. The project aims to provide guidelines for clinical practice on the appropriate use of placebo and nocebo effects mechanisms in clinical practice, and to develop training materials for higher education students in nursing and medicine. The project also intends to enrich the curricula of higher education institutions across Europe by developing a syllabus and courses on placebo and nocebo effects. To this end, multiple methods are used. The literature will be searched systematically to gain state-of-the-art knowledge that serves as input to the development of the clinical guidelines and the syllabus’s content. Practice-based knowledge is gained via interviews and surveys that are distributed among healthcare professionals. Lastly, the project aims to develop and establish an effective student-centred digital learning environment, where placebo/nocebo knowledge is readily available and where students can interact freely for optimal engagement in learning about how to optimize placebo effects and minimize

• Blease, C. (2012). The principle of parity: the ‘placebo effect’and physician communication. Journal of medical ethics, 38(4), 199-203.
• Louhiala, P. (2012). What do we really know about the deliberate use of placebos in clinical practice?. Journal of Medical Ethics, 38(7), 403-405.
• Smits, R. M., Veldhuijzen, D. S., van Middendorp, H., van der Heijden, M. J., van Dijk, M., & Evers, A. W. (2022). Integrating Placebo Effects in General Practice: A Cross-Sectional Survey to Investigate Perspectives From Health Care Professionals in the Netherlands. Frontiers in Psychiatry, 12, 2561.