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International Journal of Behavioral Medicine
Published in: International Journal of Behavioral Medicine 4/2018

01-08-2018

Decreasing the Burden of Side Effects Through Positive Message Framing: an Experimental Proof-of-Concept Study

Authors: Marcel Wilhelm, Winfried Rief, Bettina K. Doering

Published in: International Journal of Behavioral Medicine | Issue 4/2018

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Abstract

Purpose

Informing patients about treatment side effects increases the occurrence and intensity of side effects. Since the obligatory informed consent procedure in drug treatments requires transparency and nocebo research suggests that the informed consent of a drug leads to an increased occurrence of the mentioned side effects, the aim of this proof of concept study was to determine the effect of two different framings of informed consent on the occurrence, intensity, and perceived threat of side effects.

Methods

Healthy male participants (n = 80) were randomized to one of two framing groups. The positive framing group was informed that the common side effect dizziness was a sign that the drug had started to work, while the neutral framing group was told that dizziness is an unpleasant but well-known side effect. Side effects were measured after the administration of metoprolol, an antihypertensive agent. Post hoc moderator analyses investigated the effect of pre-existing negative beliefs about the general harm of medication on the framing manipulation.

Results

Metoprolol-specific drug-attributed side effects were rated significantly less threatening in the positive framing group. The between-group effect size (Cohen’s d) was small (d = 0.38, p = 0.049). Exploratory post hoc moderator analyses suggest that participants who believed that medication is a source of harmful effects benefited from positive framing, compared to neutral framing of drug-attributed side effects.

Conclusions

Positive framing was partially effective in decreasing specific side effect measures, particularly among participants with a tendency to believe that medicine is harmful. Informed consent procedures should therefore be personalized, focusing on patients with negative treatment beliefs.
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Metadata
Title
Decreasing the Burden of Side Effects Through Positive Message Framing: an Experimental Proof-of-Concept Study
Authors
Marcel Wilhelm
Winfried Rief
Bettina K. Doering
Publication date
01-08-2018
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 4/2018
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-018-9726-z

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