American Lung Association Study Explores Link between Patient Expectations and Asthma Treatment Effectiveness

(September 7, 2009)

A new American Lung Association study—soon to be an "Editor's Choice" article in the Journal of Allergy and Clinical Immunology—shows that, when it comes to asthma treatment, there may be a little power in positive thinking.

The American Lung Association's Asthma Clinical Research Centers (ACRC) completed the largest and most comprehensive study to evaluate the effects of enhanced presentation of medication ["placebo effects"] in patients with asthma. This study, funded by the Lung Association and the National Institutes of Health, investigated whether it is possible to improve the effectiveness of treatment for poorly controlled asthma by increasing the patients' expectations of the treatment, through positive messaging about the health benefits prescription drug therapy will provide.

The "placebo effect" is the beneficial effect in a patient following a particular treatment that comes from the patient's expectations of the treatment rather than from the treatment itself.

In the study 601 patients with poorly controlled asthma were randomly assigned to one of five treatment groups, including groups that received a placebo along with "enhanced" or optimistic messages about the benefits of their "treatment" and one in which patients received a placebo along with neutral messages about their "treatment."

The study found that optimistic or neutral drug messaging enhanced the placebo effect on asthma symptoms, but did not improve peak flow or other lung function tests which measure the presence and severity of the condition. This means that while positive messaging about treatment seems to improve patient's perceptions of asthma symptoms such as coughing and wheezing, it does not improve lung function itself. 

"This study is significant, because it reveals how the 'placebo effect' is affected by doctor-patient communication," said Norman H. Edelman, MD, American Lung Association Chief Medical Officer. "While the study investigates this well-documented phenomenon among patients with poorly controlled asthma, the framework can be replicated to shed light on many other chronic diseases. Bottom line, positive messages and thoughts are not as effective as proven drug therapies currently available to improve lung function in people with poorly controlled asthma. Clinicians' conversations with study participants can drastically impact a study's results and should be carefully considered."