March 1, 2019


Could Your Mindset Affect How Well A Treatment Works? (ESTHER LANDHUIS, 3/01/19, NPR)

The study randomly assigned families into two groups. Both groups received instruction on symptoms and medication use. They learned to distinguish non-life-threatening symptoms from potentially serious ones and at what point to contact a doctor, call 911 or administer epinephrine, an injectable medication for severe and potentially life-threatening allergic reactions.

Each day families completed a short online survey to report how the dose went, what time it was taken, whether symptoms developed, and how anxious they were about the symptoms. Throughout the study parents had monthly calls with a support team and had a direct line to Stanford immunologist Dr. Kari Nadeau, director of the Sean N. Parker Center for Allergy & Asthma Research, which has served as a trial site for companies developing peanut allergy treatments. In addition, families came to the clinic once a month for facilitated support sessions with other participants.

The two groups differed in just one regard. One group was told that symptoms can be an unfortunate side effect of treatment. But with the other group, session leaders reframed the message on symptoms, saying they could be a sign that the immune system is learning to desensitize -- a positive signal that the treatment is working.

At the monthly sessions, parents in the "positive signals" group were asked to come up with creative ways to reinforce this message with their children. Alissa Harris of Stockton, Calif., connected with her 7-year-old, Lucy, with a dance analogy: "When you were learning how to do the splits, it hurt your legs. But it just meant your muscles were getting stronger and getting used to doing the splits."

During the study when Lucy complained her mouth was itchy, "I would remind her, 'That's OK, that's your body getting stronger. We're fighting this peanut allergy. Just remember, your body is 'learning how to do the splits,' " Harris says.

Those reminders seemed to calm parents, too. Though both groups entered the study similarly anxious -- more than half indicated they were "kind of nervous" or "extremely nervous" -- parents who got the messaging that symptoms could be positive signals reported less nervousness as the study continued. They were also less likely to report symptoms, drop doses or contact staff about symptom concerns, compared with the other group of parents.

All participants reached the goal of tolerating one peanut by the end of the study period, and no patient needed to use epinephrine in response to symptoms.

It helps that the "allergies" are a function of parenting in the first place.

Posted by at March 1, 2019 6:19 PM