Is it in the best interest of the patients , not to highlight certain side effects of medications or procedures which might have a Nocebo response?
For example: Do we highlight to a man that beta blockers can cause impotence before starting beta-blocker??.
More patients are having negative responses to various medical interventions when they are told more than they should know about the treatment.
Are we here to in this profession to help patients benefit from the treatment modalities or are we here to do the job and safeguard our self without having to worry about what happens to the patient?
Most certainly they are, amply assisted by the pharmaceutical industry. Failure to warn of adverse reactions is one of the greatest failings of current medical practice.
We should warn about the ADR but also tell the percentage of people who might develop it in a layman language. We must safeguard ourselves first. In developing countries, doctors are getting abused physically almost every day.
I think the problem is rather complicated:
- I frequently can't provide drug treatment for patients with serious anxiety disorders, because - even if I try to give them a balanced estimate of the side effects that may happen - the package leaflet makes them so much anxiety that they prefer to remain without drug treatment and bear all of its negative consequences.
- Side effects are in some aspects personality-dependent. There are some patients, who nearly never encounter side effects, whereas others show aversive reactions to practically every drug.
. In the internet, there is an overrepresentation of aversive drug reactions. Persons, who were effectively treated without or with only minor side effects, feel less inclined to post something on the respective pages.
- I think the main point is: extensive and continuous communication with the patients about drug effects and side effects - even if you think you could spend youtr time with the patients more usefully.
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