Noetic interventions, such as energy healing, homeopathy, and therapeutic prayer, which do not use a tangible drug or medical device, are used extensively in the general population but robust studies on their effectiveness are lacking.
In MANTRA II, Mitchell Krucoff (Duke University Medical Center, NC, USA) and colleagues recruited over 700 patients undergoing elective catheterisation and percutaneous coronary intervention from nine centres in the USA. 371 patients were assigned to having an off-site prayer group pray for them and 377 had no prayer group. Prayer groups included Christian, Muslim, Jewish and Buddhist groups. In addition, half of the patients were also assigned to MIT therapy and half to no MIT therapy. MIT involved teaching the patients relaxed breathing techniques and playing them easy listening, classical, or country music during their procedure. The investigators found that neither therapy alone or combined showed any measurable treatment effect on major adverse cardiovascular events, hospital readmission and/or death. However, patients receiving MIT therapy did have less emotional distress prior to their procedures and a slightly lower 6-month mortality when compared with those not receiving the therapy.
Dr Krucoff concludes: "If we want to understand the role of human capacities and resources in the midst of our most advanced medical technologies, we have to do good science. With no notion of the actual mechanisms involved in ancient healing practices such as prayer or touch or music, structured outcomes research allows us to collect data that we can learn from in many ways. Although the primary endpoints in this study showed no definitive treatment effects, secondary analyses can be useful for hypothesis generation to guide future trials." (Quote by e-mail; does not appear in published paper)
In an accompanying editorial The Lancet comments: "Do the results of the MANTRA II study rule out the use of noetic therapies in modern scientific medicine? Such a conclusion would be premature. The contribution that hope and belief make to a personal understanding of illness cannot be dismissed so lightly. They are proper subjects for science, even while transcending its known bounds."
Contact: Dr Mitchell Krucoff MD FACC FCCP, Duke University Medical Center
Clinical Research, 508 Fulton Street, Room A3006, Durham, NC 27705, USA.
T) +1 919 286 6860 kruco001@mc.duke.edu
Medical Center News Office T) 919 684 4148/919 660 1301
Journal
The Lancet