A new study has found that asthma inhalers to have an impact on the lung’s airways, but the relief provided isn't anymore than that achieved with placebos, indicating the power of the mind.

Patients with asthma, clinically stable, reported the same amount of symptom improvement with a placebo inhaler, sham acupuncture, or the use of an Albuterol inhaler.  The study was conducted at Harvard University’s Brigham and women's Hospital in Boston, Massachusetts.

The study was composed of 46 asthma patients, randomized, double-blind treatment that was administered in a crossover design during a total of 12 sequential office visits 3 to 7 days apart after a washout.  For long and short acting bronchodilators.  The non-intervention group acted as a control for the placebo groups, which few prospective studies have tried, the researchers noted.

According to the researchers, the most likely reason for greater effectiveness of the placebo was the expectation of improvement as, "The mere ritual of treatment may affect patients’ self monitoring and subjective experience of the disease," they wrote.

According to Dr. Michael Wechsler, all three were equally better than no treatment with a 21% improvement rate.  The findings were reported in the New England Journal of Medicine.

"Placebo effects can be clinically meaningful and currently rival the effects of active medication in patients with asthma," the group concluded in the study.

Yet the results also indicate that doctors need to pay close attention to the objective measurements of asthma control, the researchers noted.

Patients could not reliably indicate the difference between the effect of the active drug and the fact of the inhaled placebo or sham acupuncture according to the researchers.

Therefore, subjective improvement in asthma should be carefully interpreted and objective outcome should be more heavily relied on for optimal asthma care, the researchers recommended.

But the patients’ subjective experiences are not simply incorrect because they don't match the objective facts of measuring pulmonary function, and actually should trump the doctor's judgment in such some symptom-defined conditions, according to Daniel E. Moerman, Ph.D., of the University of Michigan in Dearborn, argued in an editorial. .

"It is the subjective sometimes that brought these patients to medical care in the first place," he wrote.  "They came because they were wheezing and felt suffocated, not because they had reduced FEV1 (a measurement of lung volume).”

He went on to suggest that a treatment should be acceptable as long as it provides significant improvement for the patients, has a reasonable cost, and does not have negative side effects,Over the short or long-term.

Source: New England Journal of Medicine

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