Pain patients in a randomized trial did not show a significant effect of a positive consultation.
OBJECTIVE
To examine whether telling symptomatic patients that they will soon be better shortens the duration of their illness.


METHODS
We repeated an earlier trial in general practice on this subject. All our patients were reassured that they probably had no serious underlying disease. We randomized 128 patients into two groups. Half of them got a clear diagnosis and were told that they would soon be better. The others heard from their general practitioners (GPs) that they probably had no serious underlying disease but that the GP did not know exactly what was wrong; these patients were advised to come back later if necessary. For 78 patients, study protocol was followed exactly.


RESULTS
Our trial could not show an effect. The Kaplan-Meier curves of patients with a positive and negative consultation ran nearly parallel. The hazard ratio in the total group was 0.97 (95% precision interval PI=0.69-1.41) and in the optimal subgroup 0.91 (95% PI=0.57-1.46). We still cannot rule out a modest placebo effect.


CONCLUSIONS
Our finding contrasts with that of the earlier trial. We think that symptomatic patients mainly want to know that they do not have a serious problem. Often, they will miss the extra information that they get--and then they certainly cannot benefit from it.
Knipschild
Paul
P
Department of General Practice, Maastricht University, Postbox 616, 6200 MD Maastricht, The Netherlands. paul.knipschild@hag.unimaas.nl
Arntz
Arnoud
A
D000328:Adult; D001294:Attitude to Health; D005194:Family Practice; D006801:Humans; D010146:Pain / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D015990:Placebo Effect; D013997:Time Factors