Papers by Felicity Bishop
Frontiers in Pain Research
Background: Empathic communication and positive messages are important components of “placebo” ef... more Background: Empathic communication and positive messages are important components of “placebo” effects and can improve patient outcomes, including pain. Communicating empathy and optimism to patients within consultations may also enhance the effects of verum, i.e., non-placebo, treatments. This is particularly relevant for osteoarthritis, which is common, costly and difficult to manage. Digital interventions can be effective tools for changing practitioner behavior. This paper describes the systematic planning, development and optimization of an online intervention—“Empathico”–to help primary healthcare practitioners enhance their communication of clinical empathy and realistic optimism during consultations.Methods: The Person-Based Approach to intervention development was used. This entailed integrating insights from placebo and behavior change theory and evidence, and conducting primary and secondary qualitative research. Systematic literature reviews identified barriers, facilita...
Supplemental Material, sj-pdf-2-bjp-10.1177_20494637211061970 for Trusting in the online 'com... more Supplemental Material, sj-pdf-2-bjp-10.1177_20494637211061970 for Trusting in the online 'community': An interview study exploring internet use in young people with chronic pain by Anna Hurley-Wallace, Sarah Kirby and Felicity Bishop in British Journal of Pain
Supplemental Material, sj-pdf-3-bjp-10.1177_20494637211061970 for Trusting in the online 'com... more Supplemental Material, sj-pdf-3-bjp-10.1177_20494637211061970 for Trusting in the online 'community': An interview study exploring internet use in young people with chronic pain by Anna Hurley-Wallace, Sarah Kirby and Felicity Bishop in British Journal of Pain
Supplemental Material, sj-pdf-4-bjp-10.1177_20494637211061970 for Trusting in the online 'com... more Supplemental Material, sj-pdf-4-bjp-10.1177_20494637211061970 for Trusting in the online 'community': An interview study exploring internet use in young people with chronic pain by Anna Hurley-Wallace, Sarah Kirby and Felicity Bishop in British Journal of Pain
Summary of product characteristics. (PDF 140 kb)
Participant information sheet. (DOC 58 kb)
SPIRIT Checklist. SPIRIT-Checklist-download-8Jan13.doc. Recommended items to address in a clinica... more SPIRIT Checklist. SPIRIT-Checklist-download-8Jan13.doc. Recommended items to address in a clinical trial protocol and related documents. (DOC 121 kb)
Background In the UK, urinary tract infections (UTIs) are the most common bacterial infection pre... more Background In the UK, urinary tract infections (UTIs) are the most common bacterial infection presented by women in primary care. Recurrent urinary tract infections (RUTIs) are defined as three episodes of UTI in the last 12 months, or two episodes in the last 6 months. Between 20 and 30 % of women who have had one episode of UTI will have an RUTI, and approximately 25 % of these will develop subsequent recurrent episodes. RUTIs can have a significant negative effect on the quality of life, and have a high impact on health care costs as a result of outpatient visits, diagnostic tests and prescriptions. Chinese herbal medicine (CHM) has a recorded history of treatments for the symptoms of UTIs for more than 2000 years. More recent clinical research in China has provided some preliminary evidence that CHM can alleviate the symptoms of UTIs and reduce the rate of recurrence, but more rigorous investigation is required. Methods/design The RUTI trial is a double-blind, randomised, placeb...
British Journal of Pain, 2021
Background Chronic pain in young people is prevalent in the UK. Young people are digital natives,... more Background Chronic pain in young people is prevalent in the UK. Young people are digital natives, yet there has not been any online intervention developed in a UK context to help them manage chronic pain. Key to understanding the context in which young people engage with online interventions is better understanding their internet use for chronic pain management. The overarching aim of this study was to explore young peoples’ experiences of searching for information about chronic pain using the internet. This included experiences of using search engines (e.g. Google), health information websites (e.g. the National Health Service [NHS] website) and social media (e.g. Facebook and Instagram). Methods Semi-structured interviews were conducted with young people aged 16–24-years ( n = 24), online, via Microsoft (MS) Teams. The study was advertised online and via patient partner charities. Interview data was analysed using reflexive thematic analysis. Results Participants presented with a ...
BMJ Open, 2021
ObjectivesContextual components of treatment previously associated with patient outcomes include ... more ObjectivesContextual components of treatment previously associated with patient outcomes include the environment, therapeutic relationship and expectancies. Questions remain about which components are most important, how they influence outcomes and comparative effects across treatment approaches. We aimed to identify significant and strong contextual predictors of patient outcomes, test for psychological mediators and compare effects across three treatment approaches.DesignProspective cohort study with patient-reported and practitioner-reported questionnaire data (online or paper) collected at first consultation, 2 weeks and 3 months.SettingPhysiotherapy, osteopathy and acupuncture clinics throughout the UK.Participants166 practitioners (65 physiotherapists, 46 osteopaths, 55 acupuncturists) were recruited via their professional organisations. Practitioners recruited 960 adult patients seeking treatment for low back pain (LBP).Primary and secondary outcomesThe primary outcome was ba...
As part of a PhD exploring placebo effects in general practice, we conducted a systematic review ... more As part of a PhD exploring placebo effects in general practice, we conducted a systematic review of how healthcare professionals and patients understand placebos and their effects in primary care. However, there is significant ambiguity and disagreement in the literature on the nature, efficacy, and ethics of placebo treatment. This made it difficult to establish how to approach and design our review. Given such an uncertain environment, it was difficult for us to establish the orientation of our review and even more difficult to choose from the myriad possible methodologies for conducting it. In this case, we outline how by focussing on and refining a distinct logical mode of inquiry, we were able to better understand the different types of possible review and effectively evaluate and select a methodology. In a sense, this case is not about how to conduct a review, it is about how to get to the start line. We posit that having a coherent theoretical grasp of one's review orient...
BACKGROUND Cognitive behavioural therapy (CBT) is recommended in guidelines for people with refra... more BACKGROUND Cognitive behavioural therapy (CBT) is recommended in guidelines for people with refractory irritable bowel syndrome (IBS). However, availability is limited and poor adherence has been reported in face-to-face CBT. OBJECTIVE Nested within a randomised controlled trial of telephone and web-delivered CBT for refractory IBS, the objectives of this qualitative study were to: identify barriers and facilitators of engagement over time with the interventions; identify social and psychological processes of change; provide insight into trial results. METHODS Longitudinal qualitative study nested in a randomised controlled trial. Repeated semi-structured interviews at three (n=34) and twelve-months (n=25) post baseline. Participants received telephone CBT (n=17 at 3m, n=13 at 12m) or web-based CBT (n=17 at 3m, n=12 at 12m). Inductive thematic analysis. RESULTS Participants viewed CBT as credible for IBS, perceived their therapists as knowledgeable and supportive, and liked the flex...
Medicina, 2019
Background and objectives: Complementary and alternative medicine (CAM) use has been associated w... more Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients’ health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more...
Gut, 2019
ObjectiveTo evaluate the clinical effectiveness of two modes of cognitive–behavioural therapy (CB... more ObjectiveTo evaluate the clinical effectiveness of two modes of cognitive–behavioural therapy (CBT) for IBS compared with treatment as usual (TAU) in refractory IBS.DesignA three-arm randomised controlled trial assessing telephone-delivered CBT (TCBT), web-based CBT (WCBT) with minimal therapist support, and TAU. Blinding participants and therapists was not possible. Chief investigator, assessors and statisticians were blinded. Participants were adults with refractory IBS (clinically significant symptoms for ≥12 months despite first-line therapies), recruited by letter and opportunistically from 74 general practices and three gastroenterology centres in London and South of England between May 2014 to March 2016. Co-primary outcomes were IBS Symptom Severity Score (IBS-SSS) and Work and Social Adjustment Scale (WSAS) at 12 months.Results558/1452 (38.4%) patients screened for eligibility were randomised: 76% female: 91% white: mean age 43 years. (391/558) 70.1% completed 12 months of ...
BACKGROUND Placebo effects and their underpinning mechanisms are increasingly well understood. Ho... more BACKGROUND Placebo effects and their underpinning mechanisms are increasingly well understood. However, this is poorly communicated to participants in placebo-controlled trials. For valid informed consent, participants should be informed about the potential benefits and risks of participating in placebo-controlled trials. Existing information leaflets often fail to describe the potential benefits and adverse effects associated with placebo allocation. This study tested the effects of a new website designed to inform patients about placebo effects (The Power of Placebos, PoP). PoP was designed using qualitative methods in combination with theory- and evidence-based approaches to ensure it was engaging, informative, and addressed patients’ concerns. OBJECTIVE This study aimed to test the effects of PoP, compared with a control website, on people’s knowledge about placebo and the ability to make an informed choice about taking part in a placebo-controlled trial. METHODS A total of 350 ...
BMJ Open, 2017
ObjectivesThe health benefits of professional sport dissipate after retirement unless an active l... more ObjectivesThe health benefits of professional sport dissipate after retirement unless an active lifestyle is adopted, yet reasons for adopting an active or inactive lifestyle after retirement from sport are poorly understood. Elite cricket is all-encompassing, requiring a high volume of activity and unique physical demands. We aimed to identify influences on physical activity behaviours in active and insufficiently active former elite cricketers and provide practical strategies for promoting physical activity after cricket retirement.Design18 audio-recorded semistructured telephone interviews were performed. An inductive thematic approach was used and coding was iterative and data-driven facilitated by NVivo software. Themes were compared between sufficiently active and insufficiently active participants.SettingAll participants formerly played professional cricket in the UK.ParticipantsParticipants were male, mean age 57±11 (range 34–77) years, participated in professional cricket f...
Complementary Therapies in Medicine, 2016
Objectives: Despite the prevalence of acupuncture treatment in the UK, and the increasing evidenc... more Objectives: Despite the prevalence of acupuncture treatment in the UK, and the increasing evidence of safety and effectiveness, the information presented to patients by practitioners frequently contains inaccuracies. As knowledge of treatment affects both patient decision-making and treatment outcomes, this study aimed to establish what is known about acupuncture in a sample of people who had, and had not, previously experienced acupuncture. Design: A 15-item questionnaire was constructed to assess knowledge of acupuncture. Setting: Online survey of people with a history of back pain. Results: 202 participants completed the questionnaire. 66.8% of the sample was female and 33.2% male, with a mean age of 35 years (range 18-74 years). 87.6% had back pain in the past six months, 44.1% currently. 21.8% had previously received acupuncture, and 69.8% had previously read or heard information about acupuncture. On average participants answered 11.03 of 15 questions about acupuncture correctly (SD = 2.64). Items relating to common concerns about acupuncture, acupuncture efficacy, and types of acupuncture were correctly answered by ≥80% of participants. Participants possessed less knowledge of accessibility, Government legislation, and methods of administration. Conclusions: The study identified key gaps in knowledge about acupuncture among patients. In particular, many participants were unaware that acupuncture is available from the UK National Health Service and that acupuncturists are not subject to statutory regulation in the UK. These knowledge gaps should be addressed in order to increase people's understanding of and access to acupuncture.
Most family doctors have given a placebo to at least one of their patients, survey findings suggest.
British Journal of General Practice, 2013
INTRODUCTION Low back pain (LBP) is experienced by up to 84% of the population and is often accom... more INTRODUCTION Low back pain (LBP) is experienced by up to 84% of the population and is often accompanied by substantial personal, social, and economic consequences. 1-3 No single treatment is universally effective; the challenge for patients and clinicians is to identify the optimum treatment for the individual. This is reflected in current evidence-based recommendations for LBP management which incorporate not only medical and psychological approaches but also physical treatments, exercise, and complementary and alternative medicines (CAMs). 4-7 Recent models of stratified primary care based on risk of poor prognosis offer new approaches to matching patients to suitable treatments. 8 Another approach is to consider patient preferences, in line with increasing awareness of the need to promote shared decision making in health care. 9 Qualitative methods are ideally suited to patients' perspectives in an open and non-directive manner. 10 Prior qualitative research in LBP has focused on patients' lived experiences, including desires for clear diagnosis, adequate explanations, instructions and pain relief, access to a range of diagnostic and treatment services, and partnerships with clinicians. 11-15 Others have highlighted the psychological burden of LBP and struggles for understanding and legitimisation. 16-20 Few have focused on patients' perspectives on treatment. A qualitative study was conducted to explore patients' beliefs about LBP treatments. METHOD Design Focus groups were used to collect qualitative data because they: efficiently elicit qualitative data from multiple participants; produce data that reflect socially acceptable experiences, beliefs, and language; allow researchers to observe interactions between participants and thus reflect participants' own understandings. 21,22 The topic guide (Appendix 1) elicited discussion of multiple LBP treatments, with a focus on those named in the current UK clinical guidelines (medication, exercise, manual therapy, acupuncture, combined psychological and physical treatment programmes, and spinal surgery 4); these overlap with other international guidelines. 5-7 Participants The inclusion criteria were: adult (≥18 years), conversant in English, history of LBP at least 6 weeks, not caused by fracture, infection, inflammatory disorder, cancer, or nerve root compression. Participants best placed to help explore beliefs about
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Papers by Felicity Bishop