"We now know that clinically meaningful, high-quality research
can be done in this area," said Duke cardiologist Dr. Mitch Krucoff, who
co-directs the study with Suzanne Crater, a Duke nurse practitioner. "The data
are suggestive that there may be a measurable therapeutic benefit related to
noetic therapies in patients undergoing angioplasty."
Patients who received noetic therapies showed a 25 to 30 percent
reduction in adverse outcomes (such as death, heart failure, post-procedural
ischemia, repeat angioplasty or heart attack) than those without such therapies,
according to the researchers. While increasingly popular outside of mainstream
medicine, noetic therapies have not been widely studied with rigorous,
scientific research methods. This study represents one of the first such
"We know patients are very interested in these types of
treatments, particularly in the role spirituality and prayer play in their
health and health care," added Krucoff. "To best understand how to respond to
such widespread interest, we examined whether good, mainstream, fundamental
research science could be applied to these areas."
One hundred and fifty patients with acute coronary insufficiency
at the Durham Veterans Affairs Medical Center were enrolled in the prospective,
randomized study from April 1997 to April 1998. All were scheduled for invasive
cardiac procedures based on their clinical needs. In a five-way randomization,
all patients were assigned (in equal distribution) to coronary stenting with
standard care or to coronary stenting plus one of the following therapies:
guided imagery, stress relaxation, healing touch or intercessory prayer. Of the
120 patients assigned noetic interventions, 118 (98 percent) completed the
Differences in clinical outcomes between treatment groups were
not statistically significant. However, those receiving noetic treatments "had
lower absolute complication rates and a lower absolute incidence of
post-procedural ischemia during hospitalization," said Crater.
"These noetic interventions help a patient achieve a state of
calm equilibrium, or homeostasis, which puts them in a better state to help in
their own recovery process," said Jon Seskevich, a Duke nurse clinician, who
along with Crater, designed the non-prayer interventional therapies. He further
noted that those assigned to receive prayer appeared to fare even better than
those receiving the other types of noetic treatments and the control group.
To be eligible for enrollment, patients had to be experiencing
chest pain at rest (with or without acute electrocardiographic changes) and be
scheduled for invasive diagnostic angiography. All patients were managed in the
coronary care unit of the hospital before and after angioplasty.
Off-site, intercessory prayer was provided by seven prayer
groups of varying denominations around the world. The groups included Buddhists,
Catholics, Moravians, Jews, Fundamentalist Christians, Baptists and the Unity
School of Christianity.
"The name, age and illness of each patient assigned to prayer
therapy was sent to each prayer group," Crater said. "These patients had prayers
from all over the world said on their behalf for healing and recovery."
Denomination did not play a factor in the design of the study.
Prayer and standard therapy assignments remained double-blinded to patients,
family and staff. A trained volunteer performed the other noetic therapies at
bedside within one hour of the cardiac procedure.
Although small, the researchers believe the study is an
important advance in this area of medical research.
"This is an important study because it provides preliminary
information suggestive of a positive effect that needs further study in a larger
study sample," said Dr. Harold G. Koenig, associate professor of psychiatry at