Asthma and many ailments can be partially just in your head, claims research released this week. A new study finds that the power of the placebo effect versus albuterol inhalers left asthma patients thinking that real and fake drugs were doing the same level of good. The results even convinced patients they were breathing much better even if they hadn't taken a real drug and hadn't actually improved much.
Placebos don't cure diseases, but can offer relief from pain, ease gastrointestinal disorders and lower a patient's blood pressure, even though they don't have any active ingredient other than whatever a patient chooses to believe. The new study aimed to find out how the effect of a real drug compares to a fake drug in terms of the actual effect and the perceived effect.
The research studied 39 asthma patients who were randomly assigned to be treated with an albuterol asthma inhaler (a common treatment), a placebo inhaler and a sham (fake) acupuncture treatment (in which acupuncture needles are used but the clinician does not stimulate any known acupuncture points). They also underwent sessions of being treated with nothing at all.
The patients were randomly exposed to each approach during several visits during which their ability to exhale was tested. The visits were three to seven days apart for a total of 12 interventions in all.
Overall, the albuterol inhaler improved exhaling by 20%. Each of the other approaches (including no treatment) improved it by just 7% overall.
Dr. Ted J. Kaptchuk, an associate professor of medicine at Harvard Medical School said:
"The placebo doesn't change the actual breathing in asthma patients. But it changes people's experience of what's going on as much as a real drug does. It was apparent that the placebos were as effective as the active drug in making people feel better."
When questioned, the test subjects said both inhalers and the sham acupuncture improved their breathing by about the same amount, the albuterol inhaler by 50% and the fake inhaler by 45%. The acupuncture made them feel better by 46% although completely false administration. They thought doing nothing only improved it by 21%.
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City comments:
"How reliable are patients in terms of their subjective reporting of their symptoms? When a patient tells you that they feel better, and you think they really need more than what you're doing, should you stop? It really calls into question what we're doing, whether it's good enough to help the patients feel better."
The study authors had a similar view of the placebo effect. Due to the wide gap between asthma patients' self-reports and their actual lung function, the researchers concluded that for optimal asthma care, health providers should test lung function rather than rely on patients' self-assessments.
Professor Irene Tracey of the Center for Functional Magnetic Resonance Imaging of the Brain at Oxford University concludes in a separate comment:
"Doctors shouldn't underestimate the significant influence that patients' negative expectations can have on outcome. For example, people with chronic pain will often have seen many doctors and tried many drugs that haven't worked for them. They come to see the clinician with all this negative experience, not expecting to receive anything that will work for them. Doctors have almost got to work on that first before any drug will have an effect on their pain."
Sources: The New England Journal of Medicine and Science Traditional Magazine
Written by Sy Kraft