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Patient beliefs should be considered before prescribing medication
Barrett B. Ann Fam Med.2011;312-322.
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When it comes to treating symptoms of the common cold, patient beliefs and feelings should be taken into consideration, according to results of a recent study.
Bruce Barrett, MD, PhD, of the University of Wisconsin, and colleagues set out to determine if severity and duration of illness caused by the common cold are influenced by randomized assignment to open-label pills vs. conventional double-blind allocation to active and placebo pills, or no pills at all.
The researchers report in their study that participants randomly assigned to the no pills group were more likely to have longer and more severe illnesses than participants who received pills. For the subgroup “who believed in echinacea and received pills, illnesses were substantively shorter and less severe, regardless of whether the pills contained echinacea,” the authors wrote.
“Results of this trial do not support a powerful placebo effect in common cold,” the researchers wrote in the study. “The data, however, are consistent with modest placebo effects attributable to receiving pills, regardless of the content of those pills.”
In the controlled trial, Barrett and colleagues investigated the severity and duration of illness caused by new-onset common cold among 713 participants aged 12 to 80 years randomized to four groups: Those assigned no pills, those blinded to placebo, those blinded to echinacea, and those assigned open-label echinacea.
Compared with the no-pill group, results indicated the blinded-placebo group experienced shorter illness duration (7.03 vs. 6.87 days) and less severe illness (286 vs. 264 points).
In addition, those blinded to echinacea experienced shorter illness duration (6.34 vs. 6.76 days) than those in the open-label echinacea group, and severity points were 236 and 258, respectively.
Further, a subgroup of 120 echinacea-believers blinded to the placebo experienced 2.58 days shorter illness (95% CI, –4.47 to –0.68 days), and 26% lower severity scores (–97.0; 95% CI, –249.8 to 55.8 points) compared with those who received no pill, regardless of whether the pills contained echinacea.
“We interpret the results reported here as suggestive of placebo effects in common cold, especially among those who believe in a therapy, but conclude that these effects are not large, but instead, are limited and nuanced,” according to the researchers.
“People should feel free to take safe cold medicines that they believe in and doctors should consider patients’ beliefs before prescribing medicines,” Barrett told Infectious Disease News. – by Ashley DeNyse
Disclosure: Dr. Barrett reports no relevant financial disclosures.
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