Study shows a need to integrate a patient’s beliefs and expectations into drug treatment.

A thought-provoking study has recently been summarised on the National Electronic Library for Medicines of the NHS (that’s the National Health Service, for any overseas visitors!) called The effect of treatment expectation on drug efficacy: imaging the analgesic benefit of the opioid remifentanil

This is a summary – by Pharm-line – of a study by “U Bingel, V Wanigasekera, K Wiech, R Ni Mhuircheartaigh, MC Lee, M Ploner, I Tracey” which was originally published in the Science Translational Medicine (16 Feb 2011; 3(70):70ra14).

(For those unfamiliar with the term, analgesia is “a deadening or absence of the sense of pain without loss of consciousness.” – www.freedictionary.com)

The summary begins by noting that:

Evidence from behavioural and self-reported data suggests that the patients’ beliefs and expectations can shape both therapeutic and adverse effects of any given drug.

It then relates the nature of the investigations carried out to explore the accuracy of such data and concludes by saying that:

Positive treatment expectancy substantially enhanced (doubled) the analgesic benefit of remifentanil.  In contrast, negative treatment expectancy abolished remifentanil analgesia…On the basis of subjective and objective evidence, we contend that an individual’s expectation of a drug’s effect critically influences its therapeutic efficacy and that regulatory brain mechanisms differ as a function of expectancy.  We propose that it may be necessary to integrate patients’ beliefs and expectations into drug treatment regimens alongside traditional considerations in order to optimise treatment outcomes.

Research like this evidences how the relationship of belief to healthcare outcomes is increasingly being investigated. The suggested outcome offered here – to integrate the beliefs and expectations of patients into their drug treatment – is progressive and compassionate.

There is a model that works for many, including me, which goes a step further, and that is the spiritual healing approach which zeroes in on the influence that belief has as cause, as well as to acknowledge the effect it can have on cure, and which addresses these causative beliefs with an understanding of illness as rooted in mental models of life as primarily material, rather than as having a more spiritual construct. Such healing not only considers the nature of positive and negative belief on how successful a treatment will be, but takes into account belief itself as the foundation of the problem in the first place. And it taps the capacity for a spiritual understanding in an individual to act as a healing agent that works by displacing the kinds of beliefs which can produce sickness by a conscious conviction of spiritual goodness as the underlying nature of the individual.

While not everyone might want to adopt this spiritual approach to addressing their healthcare concerns, there is an ongoing record of its effectiveness which suggests that for many it is proving its worth to them in the arena of their health needs, and deserves to be more widely known and considered.

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Categories: Health

Author:Tony Lobl

I write on spirituality and health for a diversity of online media outlets, from my perspective as a Christian Science practitioner. I have been published by the Independent, the Washington Post, the Guardian, E-Hospice, MindBodyGreen and The Christian Science Monitor and I post regularly on the Huffington Post UK and BuzzFeed. In addition to writing and broadcast appearances I enjoy engaging with journalists, academics, health professionals and government officials about the possibilities for improving health outcomes through a greater emphasis on spirituality in healthcare and social care. I've also greatly valued the many opportunities I have had to travel globally for my church and to meet people around the world. My wife Jenny and I spent 10 years in Boston, USA, before returning to London in 2002, to take on a role as the media and legislative liaison for Christian Science in the UK and the Republic of Ireland. I studied at the University of Surrey earning a BSc Hons Degree in Modern Mathematics before the impact of spirituality on health caught my attention and re-shaped my career.

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One Comment on “Study shows a need to integrate a patient’s beliefs and expectations into drug treatment.”

  1. Courtenay Rule
    May 31, 2011 at 11:55 am #

    Wow, Tony! It is so good to see these effects of patients’ expectations being taken seriously in the medical literature… even if they seem to have some difficulty expressing the findings in plain English. Thanks for keeping us posted on all these developments!

    (My own research, by the way, indicates that chocolate placebos outperform all others by a huge margin. But maybe that’s just me.)

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