Current Concepts | Invied Review
16. Sham intervention—medication Openly prescribe sham medication.
With advanced prior consent, prescribe sham medication.
17. Sham interventions—physical Openly prescribe sham physical treatments.
With advanced prior consent, prescribe sham physical treatments.
18. Sham interventions—attention
Increase frequency and duration of consultations.
19. Ineffective substances Prescribe substances that are likely not to cause harm but not clearly indicated or substances unlikely to be
effective, for example, simple linctus.
20. Use side effects Tell patients about side effects associated with positive clinical outcome.
21. Matched treatments Design appearance of prescribed substance (eg, colour, packaging, taste) to match known effective
22. Maximised treatment procedures Within safety limits prescribe higher dose/higher frequency/larger pill.
Use different colour treatments.
Instigate ritualistic procedures patients can perform when taking medicines.
Maximise adherence to treatment through education, easy follow-up appointments, easy repeat
prescription arrangements, and so on.
23. Conditioning Prescribe highest tolerated dose first, then titrate downwards.
With consent, begin with active intervention, pair with a seemingly identical placebo then substitute for
placebo alone (eg, as in Sandler and Bodfish).
24. The process of informed consent Actively seek patient consent.
Provide treatment options and encourage the patient to choose from these options if they so desire.
25. Detailed history Take a detailed medical and psychosocial history/update.
Ensure the patient feels listened to, for example, through non-verbal communication and/or capturing
Ask questions about the meaning of symptoms.
26. Diagnosis/tests Provide a definitive/confident diagnosis.
Examine the patient fully.
27. Care Allow patient adequate time to tell their story and listen to them.
Validate the patient’s concerns.
Use non-verbal techniques to convey empathy, compassion, warmth.
Use touch judiciously.
28. Patient-centred communication Individualise consultation style according to a patient’s preference for example, collaborative versus
Engage in collaborative decision-making with the patient.
Develop shared treatment goals that you and the patient agree on.
29. Extra attention Give extra attention to or show more interest in a patient by seeing them more frequently, having longer
consultations or visiting at home.
Do not rush the patient.
30. Continuity of care Ensure patient is cared for by the same practitioner.
Read records before consultation.
Suggestions for clinical applications pending research into effectiveness and ethical acceptability in clinical setting.
Table (continued): Suggested potential clinical applications of procedures to elicit placebo effects in non-malignant
pain subject to further research
This table is licensed under a Creative Commons Attribution 4.0 license (CC BY 4.0). It has not been altered and is attributed to: Bishop FL, Coghlan B, Geraghty AW,
Everitt H, Little P, Holmes MM, Seretis D, Lewith G. What techniques might be used to harness placebo effects in non-malignant pain? A literature review and survey to
develop a taxonomy. BMJ Open. 2017 Jun 30; 7( 6):e015516. doi: 10.1136/bmjopen-2016-015516.