Nocebo effect in inhaler use: Patients' beliefs and treatment adherence

Background: The nocebo effect refers to the experience of nonspecific symptoms attributed to medical treatments, which cannot be explained by the pharmacological effects of the medication. This phenomenon, where symptoms are incorrectly linked to a treatment, can have significant implications for tr...

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Main Authors: Eduardo Garcia-Pachon, María J. Soler-Sempere, Sandra Ruiz-Alcaraz, Ana Ibarra-Macia, Marina Belendez-Vazquez
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Exploratory Research in Clinical and Social Pharmacy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667276625000435
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author Eduardo Garcia-Pachon
María J. Soler-Sempere
Sandra Ruiz-Alcaraz
Ana Ibarra-Macia
Marina Belendez-Vazquez
author_facet Eduardo Garcia-Pachon
María J. Soler-Sempere
Sandra Ruiz-Alcaraz
Ana Ibarra-Macia
Marina Belendez-Vazquez
author_sort Eduardo Garcia-Pachon
collection DOAJ
description Background: The nocebo effect refers to the experience of nonspecific symptoms attributed to medical treatments, which cannot be explained by the pharmacological effects of the medication. This phenomenon, where symptoms are incorrectly linked to a treatment, can have significant implications for treatment adherence and may lead to increased patient demand for medical assistance. Objective: To ascertain the frequency and types of nocebo effects attributed to inhaler use, along with the associated factors. Methods: An interview was conducted to inquire about adverse effects attributed to inhalers. Additionally, questionnaires on beliefs about medications, general and specific to inhalers, and perceived sensitivity to medications scale were administered. Adherence to inhaled therapy was established using the inhaler adherence test and the electronic prescription refill rate at the pharmacy. Results: A total of 134 patients were included, among whom 21 (16 %) attributed symptoms to inhalers that were considered to be due to the nocebo effect. Patients experiencing nocebo-related symptoms exhibited greater concerns about using inhalers, heightened sensitivity to drug effects, and lower therapeutic adherence. Conclusions: A significant proportion of patients receiving inhaler therapy associate negative symptoms that are not reasonably attributable to the inhalers themselves. Patients prone to attributing nonspecific symptoms to inhalers differ in their beliefs about medications and exhibit lower therapeutic adherence compared to others.
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spelling doaj-art-d0c72a5f3b3941d2a963380789aaa1642025-08-20T03:49:41ZengElsevierExploratory Research in Clinical and Social Pharmacy2667-27662025-06-011810060210.1016/j.rcsop.2025.100602Nocebo effect in inhaler use: Patients' beliefs and treatment adherenceEduardo Garcia-Pachon0María J. Soler-Sempere1Sandra Ruiz-Alcaraz2Ana Ibarra-Macia3Marina Belendez-Vazquez4Hospital General Universitario de Elche, Elche, Alicante, and Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Spain; Corresponding author at: Department of Respiratory Medicine, Hospital General Universitario de Elche, 03203 Elche, Alicante, Spain.Hospital General Universitario de Elche, Elche, Alicante, and Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), SpainHospital General Universitario de Elche, Elche, Alicante, and Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), SpainHospital General Universitario de Elche, Elche, Alicante, and Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), SpainDepartment of Communication and Social Psychology, University of Alicante, Alicante, SpainBackground: The nocebo effect refers to the experience of nonspecific symptoms attributed to medical treatments, which cannot be explained by the pharmacological effects of the medication. This phenomenon, where symptoms are incorrectly linked to a treatment, can have significant implications for treatment adherence and may lead to increased patient demand for medical assistance. Objective: To ascertain the frequency and types of nocebo effects attributed to inhaler use, along with the associated factors. Methods: An interview was conducted to inquire about adverse effects attributed to inhalers. Additionally, questionnaires on beliefs about medications, general and specific to inhalers, and perceived sensitivity to medications scale were administered. Adherence to inhaled therapy was established using the inhaler adherence test and the electronic prescription refill rate at the pharmacy. Results: A total of 134 patients were included, among whom 21 (16 %) attributed symptoms to inhalers that were considered to be due to the nocebo effect. Patients experiencing nocebo-related symptoms exhibited greater concerns about using inhalers, heightened sensitivity to drug effects, and lower therapeutic adherence. Conclusions: A significant proportion of patients receiving inhaler therapy associate negative symptoms that are not reasonably attributable to the inhalers themselves. Patients prone to attributing nonspecific symptoms to inhalers differ in their beliefs about medications and exhibit lower therapeutic adherence compared to others.http://www.sciencedirect.com/science/article/pii/S2667276625000435Patient beliefsPatient experiencePerceptionsTherapeutic adherence
spellingShingle Eduardo Garcia-Pachon
María J. Soler-Sempere
Sandra Ruiz-Alcaraz
Ana Ibarra-Macia
Marina Belendez-Vazquez
Nocebo effect in inhaler use: Patients' beliefs and treatment adherence
Exploratory Research in Clinical and Social Pharmacy
Patient beliefs
Patient experience
Perceptions
Therapeutic adherence
title Nocebo effect in inhaler use: Patients' beliefs and treatment adherence
title_full Nocebo effect in inhaler use: Patients' beliefs and treatment adherence
title_fullStr Nocebo effect in inhaler use: Patients' beliefs and treatment adherence
title_full_unstemmed Nocebo effect in inhaler use: Patients' beliefs and treatment adherence
title_short Nocebo effect in inhaler use: Patients' beliefs and treatment adherence
title_sort nocebo effect in inhaler use patients beliefs and treatment adherence
topic Patient beliefs
Patient experience
Perceptions
Therapeutic adherence
url http://www.sciencedirect.com/science/article/pii/S2667276625000435
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