For a study, researchers sought to understand the TCA adverse effects that may be induced by nocebo (negative placebo) effects, according to research into other chronic medical disorders. The current study examines a brief verbal intervention that enhances TCA tolerance in DGBI through nocebo effects teaching. A pilot randomized controlled study was carried out in a tertiary care gastrointestinal clinic. Participants with DGBI were randomly assigned to either “normal information,” which described the benefits and hazards of TCAs, or “augmented information,” which included a <30-second lesson on nocebo effects. Participants were emailed a survey 2 weeks following their visit to assess the frequency and severity of side effects, adequate alleviation, overall improvement, and treatment satisfaction. A total of 31 patients were randomly assigned to the study, and 22 completed the survey. The average age was 40, and 59% of the participants were female. The enhanced group attributed nominally fewer symptoms to TCAs than the standard group (1.5 vs. 4.2, effect size d=0.56, P=0.212) and reported being significantly less affected by those symptoms (13.4 vs. 38.1, P=0.037). Compared to the standard group, a marginally higher percentage of the enhanced group reported satisfactory alleviation of symptoms after 2 weeks of treatment (55% vs. 27%, respectively). This pilot investigation shows that a brief (≈ 30 s) therapeutic intervention addressing nocebo effects can improve TCA tolerance. Future, properly powered research to assess the impact of framing on clinical outcomes, particularly in chronic illnesses, will be bolstered by these findings.

Source:journals.lww.com/jcge/Abstract/2022/05000/Improving_Medication_Tolerance__A_Pilot_Study_in.14.aspx

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