Table 1

Empirical results of describing side effects as a sign treatment is active and working

Study and population*Language used to describe side effects as a sign the treatment is working*Results†
Side effectsTreatment experienceAdherenceTreatment outcomes
Fernandez et al7
66 healthy male volunteers receiving an analgesic (diclofenac) before exposure to pain
‘If you do experience a side effect, you might take this as a a reminder that the analgesic medication is active in your body…this is a signal that the drug is working’.
Communicated via video
No difference in occurrence
More likely to perceive symptoms as caused by the medication
Side effects experienced as less intenseN/APositive correlation between side effects and reported pain reduction from treatment
Howe et al8
50 adolescents undergoing a 6-month oral immunotherapy treatment for peanut allergies
‘Side effects mean that the treatment is working and your body is getting stronger and building tolerance to peanuts’.
Communicated and reinforced in various ways over a 6-month course of treatment
No difference at low treatment dose
Fewer side effects at high treatment dose
Less anxious about side effects, less likely to report dosing had not gone well when experiencing side effects and less likely to contact staff with concerns about side effectsMarginally less likely to skip or reduce doses due to treatment anxietyGreater increase in biomarker of allergic desensitisation (blood IgG4 levels)
Wilhelm et al6
80 healthy male participants between ages 18 and 35 given a hypertensive medication (metoprolol)
‘Dizziness is a sign that the drug is starting to work. If you become dizzy after taking the medication, it means that your body is responding to the beta-blocker particularly well’.
Communicated verbally
No differenceSide effects experienced as less threatening and less likely to view side effects as an adverse effect of medicationN/AN/A
  • *In all three studies, participants were randomised to either be informed that side effects were a sign the treatment was active/working or to receive a standard description of side effects. The standard description informed patients about potential side effects and provided sympathetic statements like ‘we will do our best to ensure your comfort’.

  • †Results depict the effect of describing side effects as a sign the treatment is active/working as compared with the condition that received the standard description.