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用开放式安慰剂治疗疼痛:一项针对术后疼痛患者的定性研究。

Treating Pain With Open-Label Placebos: A Qualitative Study With Post-Surgical Pain Patients.

机构信息

Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.

Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island.

出版信息

J Pain. 2021 Nov;22(11):1518-1529. doi: 10.1016/j.jpain.2021.05.001. Epub 2021 May 15.

Abstract

Prior research has shown that Open Label Placebos (OLPs; that is, placebos described honestly as inactive pills) are effective for a variety of clinical conditions, including pain. However, little is known about patient attitudes towards OLPs. We conducted qualitative interviews with n = 11 patients (73% female) who recently had hand or wrist surgery and took ≥ 1 opioid pill. Interview topics included: pain management, the placebo effect, and in particular, attitudes towards OLPs. Interviews were analyzed inductively and content-coded. Five themes were identified: 1) Role of the mind in pain and illness, 2) Shortcomings of opioids are the strengths of OLPs, 3) Perceptions of OLP effectiveness, 4) Relational aspects of OLP administration, and 5) Practical considerations for OLP implementation. Most patients agreed that, because of their transparency, OLPs are ethical. Participants indicated some degree of reluctance about using OLPs, but the majority said they would take OLPs if prescribed by a doctor. Patients noted that the primary disadvantage of opioids is their potency, which can lead to addiction or side-effects; by contrast, the primary advantage of placebos is their inertness. Results suggest that OLPs appear to be well received as a postoperative pain treatment among the patients in this study. PERSPECTIVE: This qualitative study examines how hand surgery patients view OLPs, which are placebos described honestly as inactive pills. OLPs were generally well received by patients as a treatment for pain after surgery and could be considered as an adjunctive treatment to potentially reduce reliance on prescription opioids.

摘要

先前的研究表明,开放标签安慰剂(OLP;即被诚实地描述为无效药丸的安慰剂)对各种临床病症都具有疗效,包括疼痛。然而,人们对患者对 OLP 的态度知之甚少。我们对 n=11 名最近接受过手部或腕部手术且至少服用过 1 片阿片类药物的患者进行了定性访谈。访谈主题包括:疼痛管理、安慰剂效应,特别是对 OLP 的态度。访谈内容采用归纳法进行分析和内容编码。确定了五个主题:1)思想在疼痛和疾病中的作用,2)阿片类药物的缺点是 OLP 的优点,3)对 OLP 疗效的看法,4)OLP 给药的关系方面,5)OLP 实施的实际考虑因素。大多数患者认为,由于 OLP 的透明性,它们在道德上是可以接受的。参与者表示对使用 OLP 有一定程度的不情愿,但大多数人表示如果医生开处方,他们会服用 OLP。患者注意到阿片类药物的主要缺点是其效力,这可能导致成瘾或副作用;相比之下,安慰剂的主要优点是其惰性。研究结果表明,OLP 似乎作为一种术后疼痛治疗方法在本研究中的患者中受到欢迎。观点:这项定性研究检查了手部手术患者如何看待 OLP,OLP 是被诚实地描述为无效药丸的安慰剂。OLP 作为术后疼痛的治疗方法普遍受到患者的欢迎,可作为辅助治疗方法,以减少对处方阿片类药物的依赖。

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Can the Open Label Placebo Rationale Be Optimized?开放标签安慰剂原理能否得到优化?
Front Pain Res (Lausanne). 2021 Sep 30;2:734882. doi: 10.3389/fpain.2021.734882. eCollection 2021.

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