THE TRIAL OF ASTHMA PATIENT EDUCATION (TAPE)

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。安慰剂反应通常被认为是对惰性药物的虚假、非特异性或令人困惑的反应，医护人员故意开出安慰剂的处方被认为是不光彩的。有证据表明，安慰剂治疗不仅可以引起症状反应，还可以引起神经元和免疫反应，这增加了利用安慰剂反应的成分来增强药物积极治疗效果的可能性。哮喘是一种慢性疾病，对安慰剂吸入的急性生理反应已有记录，但还没有研究重点放在长期的安慰剂效应上。在临床试验中，接受安慰剂治疗的患者通常会出现改善，但这种现象的机制尚不清楚。如果我们能够更好地理解这种安慰剂反应，我们可能能够利用这些机制来改进哮喘治疗。我们建议采用2×2析因设计和常规护理对照组进行随机临床试验，以解决有关哮喘中安慰剂效应的重要未回答问题。我们将通过改变向患者展示药物的方式，使用寻求改变药物的知识、信念和象征意义的标准化治疗演示，来改变参与者对药物将是有益的预期。19个不同临床中心的大约600名受试者将参与这项研究。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Placebo responses have often been considered to be false, non-specific, or confounding responses to inert medications, and the intentional prescription of placebos by healthcare personnel has been considered disreputable. Evidence that placebo treatments can not only evoke symptomatic responses but also can evoke neuronal and immunologic responses has raised the possibility that components of the placebo response can be harnessed to augment the effect of pharmacologically active treatment. Asthma is a chronic disorder in which acute physiological responses to placebo inhalation has been documented, but there is no research focusing on longer-term placebo effects. Patients assigned placebo treatment in clinical trials usually show improvement, but the mechanism of this phenomenon is not understood. If we can better understand this placebo response, we may be able to use these mechanisms to improve asthma therapy. We propose to conduct a randomized clinical trial using a 2X2 factorial design plus a usual-care control group to address important unanswered questions about the placebo effect in asthma. We will alter the expectancy of participants that the drug will be of benefit by varying the manner in which the drug is presented to patients, using standardized treatment presentations that seek to alter the knowledge, beliefs and symbolic meaning of the drug. Approximately 600 subjects at 19 different clinical centers will take part in this study.