The role of expectancies in the placebo effect and their use in the delivery of health care: a systematic review

Crow R, Gage H, Hampson S, Hart J, Kimber A, Thomas H
Record ID 31999008411
Authors' objectives:

The original aim was to assess the nature and extent of the placebo effect and to consider how it may be harnessed within the NHS to improve the quality of care.

The first step was to develop an approach to the review that would address specific questions about the placebo effect.

Authors' recommendations: The existing evidence justifies the use of strategies to enhance expectancies, specifically to: enhance patients' accurate expectations about medical procedures and how to cope with them and their effects; enhance patients' skills for self-management of their illness and their ability to communicate about their health problems with health care providers; enhance patients' beliefs in the benefits of effective medical treatments. Enhancement of these expectancies would be achieved by training healthcare professionals to communicate positive outcome expectations effectively and training them in interaction styles that promote patient involvement in consultations. Equally, training of patients is also recommended to increase their ability to manage their disease and its treatment, and to participate more fully in consultations. Such training is often viewed as patient education; however, it involves training in specific skills that the patient can apply in combination with medical interventions and may therefore be more usefully viewed as an integral part of health care. Through provision and implementation of such training, beneficial so-called 'placebo' effects can be increased. A number of areas for further research are identified to help increase our understanding of the expectancy mechanism in the placebo effect.
Authors' methods: Systematic review
Project Status: Completed
URL for project:
Year Published: 1999
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Physician-Patient Relations
  • Placebo Effect
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
Contact Email:
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.