Asthma Study Shows Placebo Can Help Symptoms
Researchers Find That Fake Treatment Doesn't Help Lungs, yet Asthma Patients Feel Much Better
Disease vs. Illness continued...
Franklin G. Miller, PhD, a placebo-effect expert at the National Institutes of Health, says that the study adds to previous research showing that objective medical outcomes (in this case, lung function) are not the same as patients' subjective medical outcomes (feeling less shortness of breath).
"In the ideology of medicine, objective outcomes are seen as real and subjective outcomes are seen as not real or clinically meaningful -- and that is a mistake," Miller, who was not involved in the study, tells WebMD. "A very basic goal of medicine is relief of suffering. And suffering is subjective. I am the only one who can say I am in pain or distress. So to wash that away as merely subjective is counter to one of the real goals of medicine."
On the other hand, Miller notes, drug treatment really did make patients' lungs work better. Without drug treatment, many if not all of these patients would have had a preventable asthma attack -- no matter how much better fake treatment made them feel.
The balance, Wechsler says, is to give asthma patients both medical treatment and medical care.
"I counsel other asthma doctors to interact as much as they can with their patients," he says. "We tend to interact only during doctor visits, but certainly patients experience symptoms between visits. Perhaps some interactions by phone and by email can allay some of these symptoms."
The message from this and earlier placebo studies, Kaptchuk says, is that placebos work because of the way they are provided.
"It is the care, the ritual, the interaction, that can actually change the way people feel about their disease," he says. "We give empathy and warmth. We offer a little confidence, a little hope, a little attentive listening. We give some kind of clear statement that the doctor is in this with you, not just, 'I am going to try,' but 'I am really in your camp and am going to do everything possible to make this work.'"
One significant thing about the current study, Miller notes, is that it appears in the New England Journal of Medicine. He says this means that placebo research has moved from the fringes to the center of medical research.