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2020, Number 3

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Rev Cubana Neurol Neurocir 2020; 10 (3)

Placebo effect in contemporary medicine

Gómez FL

Language: Spanish
References: 66
Page: 1-22
PDF size: 314.09 Kb.


ABSTRACT

Objective: To explain the concept of placebo and placebo effect, as well as other processes related to the therapeutic response.
Acquisition of evidence: A bibliographic search was carried out in PubMed, Scopus and EMBASE databases until May 2020. The keywords were used: “placebo”, “placebo effect”, “and placebo response”, “placebo intervention”. One hundred seven articles were selected in English and Spanish: review (35), clinical trials (26), meta-analysis and systematic reviews (10), which addressed methodological aspects on the use and effect of placebo. Thirty six articles were excluded due to various methodological errors.
Results: The placebo effect is present in pharmacological and non-pharmacological interventions. It is influenced by patient expectation, Pavlovian conditioning mechanisms, learning, and treatment characteristics. The use of placebos can be responsible for improvement of up to 60% of symptoms in patients. There are also other processes that modulate the response to treatment, such as observation (Hawthorne), regression to the mean, the natural history of the disease, and the Pygmalion effect. Developing well-designed clinical trials is essential to supporting the successful introduction of new treatments.
Conclusions: Placebo is any inert substance or intervention, used with curative intent. The placebo effect consists of the improvement of symptoms that results from the use of a placebo. Experimental observation, regression to the mean and the natural history of the disease are factors that influence the appreciation of the therapeutic response.


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