Placebo treatments didnt improve an objective measure of asthmatics lung function. But they sure did make patients feel better.
A study published in the New England Journal of Medicine took 39 asthma patients and had them make 12 visits each to a medical facility, each time after having been off long-acting asthma medications for 24 hours. On each visit, a patient was randomly assigned to either a real albuterol inhaler, a placebo inhaler, sham acupuncture treatment, or no intervention. (So at the end of the study each patient had been given each treatment three times.)
Their lung function was measured every 20 minutes for two hours. At each visit, the also patients scored their perceived symptom improvements on a scale of one to 10.
Researchers found stark differences between the objective measure and how patients actually felt. Going by lung function, albuterol produced a 20% improvement while the three other treatments produced a 7% response. In other words: no placebo effect.
But patients reported about the same degree of symptom improvement for albuterol, the placebo inhaler and the fake acupuncture treatment (respectively, a 50%, 45% and 46% improvement), much greater than the 21% improvement experienced by those given no treatment at all.
Isnt it enough to feel better? In the case of some conditions, yes, says senior author Ted Kaptchuk, director of the program of placebo studies at Beth Israel Deaconess Medical Center and an associate professor of medicine at Harvard Medical School.
He tells the Health Blog that when it comes to things like asthma or cholesterol or diabetes, while patient reports are important, its key to keep tabs on objective measures, too. I may feel great, but if my cholesterol level isnt budging, the statin isnt working and my risk for another heart attack isnt going down.
But in conditions such as depression, pain and insomnia, the subjective response is the main thing being treated. If Im depressed, take a pill and no longer feel depressed, by definition the medicine is working. Theres no blood or imaging test used to confirm whether my condition is being fixed.
Placebos may play an important role in those and similarly subjective conditions, Kaptchuk says. He was an author of a study published in December that showed 60% of patients with irritable bowel syndrome given a placebo reported an improvement in their symptoms, compared to 35% who received no additional treatments. The patients receiving the pills knew they were placebos and still they felt better.
Kaptchuk says it shows how powerful act of caring for people not the procedures and drugs themselves can be. The ritual of medicine is an important component of care, he says. And he adds that even for conditions like asthma where drugs are necessary, a strong doctor-patient interaction might strengthen the medications benefit.
Bonus: Placebos Might Work Even Better With a Brand Name
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