[NOCEBO EFFECT: AN ADVICE TO A PRACTITIONER].Urologiia. 2015 May-JunU
Nocebo effect is the onset or exacerbation of unwanted symptoms (adverse reaction) as a reaction to medical treatment. The nocebo effect is very common both in clinical practice and in clinical trials. Medical practitioner's knowledge of the patient's predisposition to nocebo effects can affect the management strategy and building doctor-patient relationship. It allows prediction and prevention of nocebo effect, especially if the patient has negative clinical encounters in the past.There is a dilemma: to inform the patient about the side effects and complications of treatment, which may lead to the development of nocebo effect and adversely influence the patient health and treatment outcomes, or conceal the information, thus infringing the patient civil rights. Solving this contradiction and minimizing the risk of nocebo effect allows choosing the proper strategy of doctor-patient communication. It is important not to ignore the various psychological, medical and organizational measures aimed at improving the patient comfort in the course of treatment. This prevents the accumulation of negative treatment experiences and is the key to successful treatment and prevention of nocebo effect.