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Prayer, Noetic Studies Feasible; Results Indicate Benefit

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Duke Health News 919-660-1306

DURHAM, N.C. - Cardiac patients who received intercessory prayer in
addition to coronary stenting appeared to have better clinical outcomes than
those treated with standard stenting therapy alone, according to researchers
at Duke University Medical
Center
.

Their results further suggest that using rigorous scientific methods to
study the therapeutic value of prayer and other noetic interventions appears
feasible and warrants larger-scale, more definitive investigations. Noetic
interventions are defined as "a healing influence performed without the use
of a drug, device or surgical procedure," said the researchers.

Results of the phase I feasibility-pilot, known as the MANTRA (Monitoring
and Actualization of Noetic TRAinings) Project, appear in the Nov. 1 issue
of the
American Heart Journal.

"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 efforts.

"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 therapeutic assignment.

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 Duke University Medical Center, and one
of the study authors. "Some of the greatest scientific achievements have
come from those who step outside of the box, and I believe that is what this
study does. The results tend to lean toward prayer helping people, but more
study is needed."

Research is continuing. Phase II of the MANTRA project has already
enrolled nearly 500 patients out of an enrollment target of 1,500 patients.
The larger study is underway at nine sites throughout the U.S., including Duke University Medical Center,
Columbia-Presbyterian Hospital in New York City, Washington Heart Center in
Washington, Abbott Northwestern Hospital in Minneapolis, Scripps
Clinic/Scripps Mercy Hospitals in San Diego, Geisinger Clinic in Danville,
Pa., Florida Cardiovascular Center in Atlantis, Fla., and the Durham
VAMC.

Preliminary data from this pilot study were previously reported at the
71st meeting of the American Heart Association in 1998. The
American Heart Journal article represents the complete, tabulated,
peer-reviewed results of the phase I study. Funding was provided in part by
grants from G.E.-Marquette Electronics, Milwaukee; the Institute of Noetic Sciences, Sausalito,
Calif.; the Bakken Family Foundation (Hawaii); the Heart Center, Duke University Medical Center; and the
Duke Clinical Research
Institute
.

Other authors of the study include: Cindy L. Green, Ph.D., Arthur C.
Maas, MD, James D. Lane, Ph.D., Karen A. Loeffler, Kenneth Morris, MD, and
Thomas M. Bashore, MD.

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