A Harvard Medical School study found that while placebos had no effect on lung function, when it came to patient-reported outcomes, placebos were equally effective in helping relieve patients’ discomfort and self-described asthma symptoms as the standard medical treatment—an albuterol bronchodilator. The study examined the impact of two different placebo treatment—a placebo albuterol inhaler and sham acupuncture—against the albuterol inhaler. The findings appear in the New England Journal of Medicine.
“We were trying to understand whether a placebo effect exists and, if so, whether it was similar with regard to both objectively and subjectively reported measures, and whether similar effects could be observed using different types of placebo,” said Michael Wechsler, MD, associate director of the Asthma Research Center at Brigham Women’s Hospital and assistant professor of medicine at Harvard.
The study randomly assigned 39 patients with chronic asthma to undergo treatment with an active albuterol inhaler, a placebo albuterol inhaler, sham acupuncture, or no intervention. The patients reported statistically significant symptomatic improvement with albuterol, as well as with the placebo inhaler and the sham acupuncture. Little improvement was reported by the patients who received no intervention.
Meanwhile, the researchers found that treatment with the albuterol inhaler resulted in a 20% increase in FEV1. The two placebo treatments and the no intervention group showed only a 7% increase in FEV1.
These findings, say the researchers, suggest that physicians and investigators reconsider the implications of subjective, patient-reported outcomes in clinical trails, and consider having a “placebo for the placebo” to monitor a patient’s natural history.
“It’s clear that for the patient, the ritual of treatment can be very powerful,” says Ted Kaptchuk, director of the Program in Placebo Studies at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard. “This study suggests that in addition to active therapies for fixing diseases, the idea of receiving care is a critical component of what patients value in health care. In a climate of patient dissatisfaction, this may be an important lesson.”
Source: Beth Israel Deaconess Medical Center