The cultural differences in the placebo effect. How taste, trust and cultural sensitivity can affect global health.
Irritable bowel syndrome (IBS) affects 10-15% of people around the world. It is a chronic gastrointestinal disorder with symptoms including abdominal pain, discomfort, diarrhoea and constipation. Most medications are used to treat these symptoms independently of each other and few treatments relieve the symptoms of IBS as a whole (Drossman et al. 2010). Studies have demonstrated that there is a substantial, clinically significant placebo effect for IBS. This then led Harvard researchers to investigate if using placebo for IBS could be both ethical and effective.
There is something very empowering about the placebo effect and the idea that we can heal ourselves. For decades, we've known about the placebo effect, but we've been unable to use it ethically in healthcare. One of the primary obstacles to using placebos in healthcare, was informed consent. It was thought that placebos necessarily required deception - the patient had to believe it would work. However, renowned placebo researcher - Ted Kaptchuk - realised that no one had ever put that theory to the test. So he began a research programme into identifying if people could respond to placebos even if they knew they were taking placebos. The results have changed how we think about placebos in healthcare.
Did you know that placebo effects and nocebo effect can be evoked without a placebo; or how about the unspoken ethics code when it comes to prescribing placebos? In a talk by Dr Luana Colloca we learn about the conflicts, ethics and future use of the placebo effect in clinical practice. Here, we summarise some of the key ideas in Dr Colloca's talk.
In 1983, a groundbreaking study was published demonstrating that architectural environment influences recovery from surgery. Benedetti described the placebo as "the whole ritual of the therapeutic act", so why shouldn't that also include the clinical environment? In this article, we explore the 1983 study and the implications of this in global health.
In 2013, a survey of UK primary care physicians revealed that 97% of them had used placebos in their career, with 77% of them using placebos at least once a week! We take a look at this and what it means for both patients and doctors.
Alain de Botton's "The Architecture of Happiness" was one of the books that first got me thinking about how buildings can physically affect us. At Yekize, we believe that the placebo effect, is not just about what you take, but also about other factors such as the doctor-patient relationship and the clinical setting - so why not take architecture into consideration as well?
Mr Wright is a case dating back to 1957, in which a patient supposedly made a miraculous recovery via placebo, before relapsing straight-away upon discovering his treatment was a sham. Placebo researchers everywhere wish this case were true, but current research into the placebo effect throws the shadow of doubt on to this incredible story.
In 2016, Michael Murphy did one of my all time favourite TED Talks. It's entitled 'Architecture that's built to heal' and he discusses architecture as a means for physical, emotional and societal healing. His inspiring talk made me feel that this is something we should make more of. https://www.youtube.com/watch?v=MvXZzKZ3JYQ Getting inspired Michael Murphy was inspired to action … Continue reading “Great architecture can heal”
What happens when a treatment has a 5% mortality rate and no one's making anything better?I recently finished reading Prof. Peter Kennedy's book 'The Fatal Sleep'. It tells the story of Human African Trypanosomiasis (African Sleeping Sickness). HAT is one of the WHO's neglected tropical diseases. The disease is complex, but in the late stages, … Continue reading Did post-colonialism leave a drug vacuum?