Researchers found that individuals from Black, Asian, and other Minority Ethnic (BAME) groups who reported feeling discriminated against by their GP were more likely to experience medication side effects and were less likely to take their medication as prescribed.
The study, published in the Journal of Racial and Ethnic Health Disparities, surveyed over 800 participants in the UK, representing the four largest racial/ethnic groups. It explored whether negative expectations, potentially fueled by experiences of discrimination, could be triggering a "nocebo effect" - where negative thoughts and beliefs about a medication lead to the experience of adverse effects, even if they aren't directly caused by the drug itself.
The findings revealed a significant link: patients who perceived discrimination during their GP consultation reported more side effects and were less likely to adhere to their medication regimen. Further analysis suggested that negative expectations about side effects played a crucial role in this connection.
The study also highlighted that within the BAME groups, participants identifying as mixed race were less likely to report side effects compared to White participants who experienced the same level of discrimination. This suggests a complex interplay of factors influencing the nocebo effect.
‘This study has helped to identify perceived discrimination in healthcare settings as a potential nocebo-related predictor which could be contributing to poor medication experience and lower adherence. Importantly this factor is modifiable and could serve as a critical intervention point to reduce patient’s side-effect experience and improve adherence to their medications while improving health equity. Future research following patients over a period of time from first prescription, and exploration of the types of perceived discrimination individuals are experiencing in health care are now needed to confirm the identified associations and inform potential interventions.’ Dr Rebecca Webster lead author.
The researchers emphasise that while previous studies have examined the impact of perceived discrimination on overall health outcomes, this is among the first to specifically investigate its link to the nocebo effect. This "nocebo gap" in understanding could have significant implications for medication adherence and health equity within diverse populations.