INTRODUCTION Communication between medical staff and patients about treatment efficacy elicits expectations of benefit and improves treatment outcomes. While demonstrated in multiple studies via different research methodologies, uniform communication protocols have not been adopted in clinical practice. Here, we summarize the results of two sister studies aimed at bridging this gap. METHODS Women undergoing C-section (study 1, randomized controlled trial) and patients undergoing general or otolaryngologic surgeries (study 2, control group design) were recruited and assigned to the "regular communication" (RC) or "enhanced communication" (EC) arms. The EC arm received positive information about treatment, while the RC arm received no such information. In both studies, the primary outcome was change in pain intensity; in study 2, an additional outcome was morphine consumption. RESULTS Eighty women successfully completed study 1, and 102 patients successfully completed study 2. In both studies, significant time*group interactions were observed (p < 0.001). The analgesic effect was virtually twice as large in the EC arm compared to the RC arm. In study 2, in the last two timepoints of assessment, participants in the EC arm also consumed fewer doses of opioids than participants in the RC arm (p < 0.001). No significant differences were found in vital signs. CONCLUSIONS We provide ecological evidence that positive information about treatment significantly decreases pain and opioid consumption during routine clinical care. This study and others could encourage healthcare providers to harness the powerful effects of patients' expectations of benefit to improve analgesics outcomes and, potentially, the outcomes of other symptoms.

中文翻译：

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好词的力量：在临床环境中增强镇痛药的疗效。


引言 医务人员和患者之间关于治疗效果的沟通可以引起对益处的期望并改善治疗结果。虽然通过不同的研究方法在多项研究中得到证明，但统一的通信协议尚未在临床实践中采用。在这里，我们总结了两项旨在弥合这一差距的姊妹研究的结果。方法 招募接受剖腹产的女性 （研究 1，随机对照试验） 和接受普通或耳鼻喉外科手术的患者 （研究 2，对照组设计） 并分配到 “常规沟通” （RC） 或 “增强沟通” （EC） 组。EC 组收到了有关治疗的积极信息，而 RC 组没有收到此类信息。在这两项研究中，主要结局是疼痛强度的变化;在研究 2 中，另一个结果是吗啡消耗。结果 80 名女性成功完成了研究 1,102 名患者成功完成了研究 2。在这两项研究中，都观察到显着的时间*组相互作用 （p < 0.001）。与 RC 组相比，EC 组的镇痛效果几乎是 RC 组的两倍。在研究 2 中，在评估的最后两个时间点，EC 组的参与者消耗的阿片类药物剂量也比 RC 组的参与者少 （p < 0.001）。生命体征未发现显著差异。结论 我们提供的生态学证据表明，在常规临床护理期间，有关治疗的积极信息可显着减轻疼痛和阿片类药物消耗。这项研究和其他研究可以鼓励医疗保健提供者利用患者对益处期望的强大影响来改善镇痛药的结果，并可能改善其他症状的结果。