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Investigating Hope and Expectations in Open-Label Placebos

Not Applicable
Completed
Conditions
Pain
Interventions
Other: OLP Hope
Other: OLP Expectation
Other: DP
Other: Placebo cream
Other: Heat pain
Registration Number
NCT03517644
Lead Sponsor
Philipps University Marburg Medical Center
Brief Summary

Research has shown that placebo effects contribute substantially to clinical outcomes. Recent evidence suggests that placebos remain effective even if they are openly described as placebos (so-called Open-Label Placebos). In this study, the investigators examine hope and expectations as components of open-label placebos in an experimental study investigating pain..

Detailed Description

A growing body of research has indicated that placebos contribute substantially to clinical outcomes. Yet, the implementation of deceptive placebos in clinical practice is incompatible with key principles of openness and patient autonomy. However, recent research suggests that placebos remain effective even if they openly described as placebos (so-called Open-Label Placebos (OLP)), hence questioning the necessity of deception in clinical trials. However, research identifying the specific mechanisms underlying OLP is lacking. Therefore, the current study aims to examine hope and expectations as components of OLP in pain.

For this purpose, experimentally induced heat pain is examined. First, all participants receive heat pain stimuli and evaluate them. Next, participants are randomly assigned to one of four groups: (1) a traditional deceptive placebo (DP) group, which is told that they receive an effective analgesic cream, (2) an OLP group inducing hope among the participants that the placebo cream could help them tolerating painful stimuli (OLP hope), (3) and OLP group raising the expectation that the placebo cream will help participants tolerating heat pain (OLP expectation), (4) a control group receiving no cream. Finally, participants receive and evaluate heat pain again.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • sufficient German language knowledge
  • at least 18 years old
Exclusion Criteria
  • current mental disorder
  • current medical disease
  • studying psychology or medicine
  • pregnancy or breastfeeding period
  • intake of drugs
  • severely visually impaired

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
OLP with Hope (OLP Hope)Placebo creamAfter pretreatment heat pain assessment, participants are informed that they are about to receive an placebo cream. They are told that the cream has no active pharmacological ingredient. However, using verbal instructions, the investigator aims to induce hope among the participants that the cream could have a positive effect. Next, the posttreatment pain assessment is conducted.
OLP with Expectations (OLP Expectation)Heat painAfter pretreatment heat pain assessment, participants are informed that they are about to receive an placebo cream. They are told that the cream has no active pharmacological ingredient. However, using verbal instructions, the investigator aims to raise expectations among the participants that the cream will have a positive effect. Next, the posttreatment pain assessment is conducted.
OLP with Expectations (OLP Expectation)Placebo creamAfter pretreatment heat pain assessment, participants are informed that they are about to receive an placebo cream. They are told that the cream has no active pharmacological ingredient. However, using verbal instructions, the investigator aims to raise expectations among the participants that the cream will have a positive effect. Next, the posttreatment pain assessment is conducted.
Deceptive Placebo (DP)Placebo creamAfter pretreatment heat pain assessment, participants are informed that they are about to receive an effective analgesic cream. In fact, they receive a placebo cream. Next, the posttreatment pain assessment is conducted.
OLP with Hope (OLP Hope)OLP HopeAfter pretreatment heat pain assessment, participants are informed that they are about to receive an placebo cream. They are told that the cream has no active pharmacological ingredient. However, using verbal instructions, the investigator aims to induce hope among the participants that the cream could have a positive effect. Next, the posttreatment pain assessment is conducted.
OLP with Hope (OLP Hope)Heat painAfter pretreatment heat pain assessment, participants are informed that they are about to receive an placebo cream. They are told that the cream has no active pharmacological ingredient. However, using verbal instructions, the investigator aims to induce hope among the participants that the cream could have a positive effect. Next, the posttreatment pain assessment is conducted.
OLP with Expectations (OLP Expectation)OLP ExpectationAfter pretreatment heat pain assessment, participants are informed that they are about to receive an placebo cream. They are told that the cream has no active pharmacological ingredient. However, using verbal instructions, the investigator aims to raise expectations among the participants that the cream will have a positive effect. Next, the posttreatment pain assessment is conducted.
Deceptive Placebo (DP)DPAfter pretreatment heat pain assessment, participants are informed that they are about to receive an effective analgesic cream. In fact, they receive a placebo cream. Next, the posttreatment pain assessment is conducted.
Deceptive Placebo (DP)Heat painAfter pretreatment heat pain assessment, participants are informed that they are about to receive an effective analgesic cream. In fact, they receive a placebo cream. Next, the posttreatment pain assessment is conducted.
ControlHeat painAfter pretreatment heat pain assessment, this group does not receive an intervention targeting pain sensation prior to the posttreatment pain assessment.
Primary Outcome Measures
NameTimeMethod
Change in pain intensity scaleBaseline and 45 minutes

Change in subjective pain intensity assessed using a visual analogue scale (ranging from 0 to 100, with higher values reflecting more pain intensity)

Secondary Outcome Measures
NameTimeMethod
Change in pain unpleasantness scaleBaseline and 45 minutes

Change in subjective pain unpleasantness assessed using a visual analogue scale (ranging from 0 to 100, with higher values reflecting more pain unpleasantness)

Change in physiological heat pain thresholdBaseline and 45 minutes

Change in the individual heat pain threshold (the point when the stimulus changes from being warm to being painful)

Change in physiological heat pain toleranceBaseline and 45 minutes

Change in the individual heat pain tolerance (the point when participants cannot stand the heat pain stimulus any longer)

Trial Locations

Locations (1)

Philipps-University of Marburg

🇩🇪

Marburg, Hessen, Germany

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