Placebo on Prescription: Hepatitis C Transplants, Genes and Back Pain
Inside Health
BBC
4.4 • 575 Ratings
🗓️ 9 October 2018
⏱️ 28 minutes
🧾️ Download transcript
Summary
Until recently it was assumed that placebo pills would only produce a therapeutic benefit if patients didn't know that's what they had been given. But there are early suggestions that patients can still get symptom relief even when they're told that there is no active ingredient at all in the pills they've been given. So should placebo pills be openly prescribed to patients? Ted Kaptchuk, Professor of Medicine at Harvard University tells Mark he believes open-label placebo could, if evidence continues to accumulate, form part of the physician's therapeutic toolbox. But Inside Health's Dr Margaret McCartney urges caution. She says there is insufficient evidence about the long-term impact on symptoms.
Nearly 500 people died on the transplant waiting list last year and if you're one of the 7,000 waiting for a life-saving organ, how would you feel if the organ on offer came from a donor infected with hepatitis C? Such organs are about to be available on the NHS and this radical change has come about because of the revolution in treatment for this potentially-serious blood borne viral infection. Yes recipients of Hepatitis C positive organs will be infected by the virus after transplant, but a short course of treatment, direct acting antivirals, will then cure them. Consultant kidney and transplant specialist Dr Adnan Sharif from Queen Elizabeth Hospital in Birmingham explains why patients on the waiting list should have this option available to them and Professor James Neuberger from the UK government's advisory committee on the Safety of Blood, Tissues and Organs, tells Mark why SaBTO have recommended this policy change and are now keen to see it implemented.
Back pain is common but most of us recover in a matter of weeks. For 10-20% of people though, the pain and discomfort doesn't go away and they suffer chronic pain throughout their lives. What many people don't know is the extent to which genes feature in back pain - it runs in families. Frances Williams is Professor of Genomic Epidemiology at Kings' College, London and a consultant rheumatologist at Guy's and St Thomas' NHS Trust. She tells Mark about the genetic clues that emerged from the world's largest ever study of 500,000 individuals with chronic back pain across five countries.
Producer: Fiona Hill
Transcript
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| 0:39.5 | Transplants, surgeons in the UK, |
| 0:41.5 | will soon be allowed to use organs from donors infected with hepatitis C. |
| 0:46.3 | But would you be happy to receive an infected liver, heart or kidney? |
| 0:51.4 | And what does a transplant specialist think? |
| 0:56.4 | I would, on the balance of evidence just now, I would go for the hepatitis C kidney. And what does a transplant specialist think? I would, on the balance of evidence just now, |
| 1:01.2 | I would go for the hepatitis C kidney because it would be a better kidney. And the evidence suggests within 12 weeks of the treatment, the hepatitis C will be cured. For me, it's a no-brainer. And the genetics |
| 1:07.7 | of back pain. Apparently, it's neither all in the back nor all in the mind. |
| 1:13.7 | The surprise to me was that these are genes that are not chronic pain genes, |
| 1:18.8 | but that they're structural spine genes. |
| 1:21.1 | And we've also found a surprising overlap with genes for anxiety and depression. |
| 1:26.0 | But first, placebos. They're all over the news recently, |
| 1:29.5 | thanks to the latest episode |
| 1:31.1 | of the Horizon TV documentary series, |
| 1:33.6 | The Placebo Experiment, |
| 1:35.3 | which got us thinking here at Inside Health |
| 1:37.2 | about the mysteries of the placebo effect. |
| 1:40.1 | What does the evidence actually tell us |
| 1:42.1 | how might placebos be working? |
| 1:44.6 | And should we do more to harness their power? |
| 1:47.4 | If you missed the program, it was a BBC experiment to assess the impact of |
| 1:51.2 | placebos in people with chronic pain. |
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