Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care

Imagine you have recommended statin therapy to a patient with diabetes. A few weeks later, the patient experiences leg pain and stops it. Was this patient’s leg pain caused by the statin? Or was it a nocebo effect? Muscle symptoms in placebo-controlled trials of statin therapy range from 3-5%, while rates in real-world observational studies are between 15-20%. Ambulatory care pharmacists have an important role in recognizing and managing placebo and nocebo effects. Understanding the placebo effect allows clinicians to harness the power of placebos. Reframing risks during patient education may decrease nocebo effects.

Guest Authors:  Sara Wettergreen, PharmD, BCACP and Joseph Nardolillo, PharmD

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