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Research ArticleFirst Five Years

The nocebo effect in current practice

Kalpit Agnihotri
Canadian Family Physician November 2020, 66 (11) 862-864;
Kalpit Agnihotri
Primary care physician with special interests in sports and exercise medicine and occupational injuries practising in Calgary, Alta.
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  • RE: The power of words and expectation
    Edward S Weiss
    Published on: 25 November 2020
  • Published on: (25 November 2020)
    RE: The power of words and expectation
    • Edward S Weiss, Family Physician, n/a

    I thank Dr. Agnihotri for his commendable article on the immense power we as care providers and prescribers can wield when it comes to how our patients respond to medication. The placebo and nocebo effects are inextricably linked to how we frame our discussions about therapeutic options, and the conscious or unconscious expectations that are thereby created. One particular approach that I have found tremendously helpful to navigate these tricky waters in my own practice is the Medication Interest Model, described in detail in Dr. Shawn Christopher Shea's 2018 book of the same name (1). Dr. Shea, a psychiatrist with decades of expertise in the careful art of interviewing, illuminates with many practical examples how we can tailor our discussions to respond to patients' concerns and overcome the barrier of medication disinterest that often seems endemic. I suspect that such an approach may yield promising results with respect to decreasing the nocebo effect as well, and I would recommend this publication to all my colleagues who have an interest in more effective therapeutic counselling.

    (1) Shea SC. The Medication Interest Model: How to Talk With Patients About Their Medications, 2nd Edition. Wolters Kluwer, 2018.

    Competing Interests: None declared.
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Canadian Family Physician: 66 (11)
Canadian Family Physician
Vol. 66, Issue 11
1 Nov 2020
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The nocebo effect in current practice
Kalpit Agnihotri
Canadian Family Physician Nov 2020, 66 (11) 862-864;

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Kalpit Agnihotri
Canadian Family Physician Nov 2020, 66 (11) 862-864;
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