Have you ever felt pressured to provide a patient with something at the time of discharge? Something, anything to ease their suffering for an illness of unalterable benign progression? Never? You cold-hearted bastard.
This tiny trial, despite its small size, provides yet another beautiful look at the magical healing power of placebo. Or, more accurately, rather than healing power, at least the satisfying power. After all – most families in the ED at two in the morning are not there because their child is awake from coughing, but because the parents are.
This trial, in the same vein of several honey trials before it, compared no treatment, a placebo treatment (grape-flavored water), and agave nectar for the treatment of pediatric cough-related illness. Agave nectar was chosen for its similarity to honey, while not carrying the hypothetical botulism risk. With ~40 patients in each group, all patients improved during the duration of the study. However, despite the small sample, both agave nectar and placebo provided durable advantage over no treatment across all surveyed measures of patient and parent comfort. There was, however, no difference between placebo and agave nectar – or, if there was, it was too small to be detected in this study.
What is most remarkable about this study is the authors discussion – that placebo treatments could be considered ethical, even when no benefit to such treatment is found in controlled studies. Providing patients – or parents – with, at least, an inexpensive, harmless treatment option takes advantage of the power of belief, to the extent that real patient/parent-oriented benefits may be observed.
Unfortunately, the lead author of this study was a paid consultant to Zarbee’s Inc (a maker of “natural” over-the-counter remedies) at the time the study was initiated, and Zarbee’s provided funding for the study. But, thanks to their contribution to science, we now know they only work as well as you expect ….
“Placebo Effect in the Treatment of Acute Cough in Infants and Toddlers”
http://www.ncbi.nlm.nih.gov/pubmed/25347696
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