Clinical Investigation
Surgery
Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer

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Abstract

Background

Intercessory prayer is widely believed to influence recovery from illness, but claims of benefits are not supported by well-controlled clinical trials. Prior studies have not addressed whether prayer itself or knowledge/certainty that prayer is being provided may influence outcome. We evaluated whether (1) receiving intercessory prayer or (2) being certain of receiving intercessory prayer was associated with uncomplicated recovery after coronary artery bypass graft (CABG) surgery.

Methods

Patients at 6 US hospitals were randomly assigned to 1 of 3 groups: 604 received intercessory prayer after being informed that they may or may not receive prayer; 597 did not receive intercessory prayer also after being informed that they may or may not receive prayer; and 601 received intercessory prayer after being informed they would receive prayer. Intercessory prayer was provided for 14 days, starting the night before CABG. The primary outcome was presence of any complication within 30 days of CABG. Secondary outcomes were any major event and mortality.

Results

In the 2 groups uncertain about receiving intercessory prayer, complications occurred in 52% (315/604) of patients who received intercessory prayer versus 51% (304/597) of those who did not (relative risk 1.02, 95% CI 0.92-1.15). Complications occurred in 59% (352/601) of patients certain of receiving intercessory prayer compared with the 52% (315/604) of those uncertain of receiving intercessory prayer (relative risk 1.14, 95% CI 1.02-1.28). Major events and 30-day mortality were similar across the 3 groups.

Conclusions

Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of receiving intercessory prayer was associated with a higher incidence of complications.

Section snippets

Study design

The STEP was a multicenter randomized clinical trial, monitored by an independent Data Safety Monitoring Board (DSMB). The institutional review board at 6 participating hospitals (Integris Baptist Medical Center, Oklahoma City, OK; Beth Israel Deaconess Medical Center, Boston, MA; Washington Hospital Center, Washington, DC; Baptist Medical Center, Memphis, TN; Mayo Clinic, Rochester, MN; St Joseph's Hospital, Tampa, FL) approved the protocol, all amendments, and fall procedures for obtaining

Patient characteristics

Patients were enrolled between January 1998 and November 2000. Of 3295 eligible patients, 1493 did not wish to participate, and 1802 patients enrolled (Oklahoma, 548; Massachusetts, 492; Washington, DC, 284; Tennessee, 256; Minnesota, 200; Florida, 22) (Figure 1). Intercessory prayer was provided according to the protocol to 99% (1192/1205) of patients randomized to groups 1 and 3, over the course of the study period (1046 days). The overall daily mean of intercessors was 33 (range 10-58).

Discussion

Our study had 2 main findings. First, intercessory prayer itself had no effect on whether complications occurred after CABG. Second, patients who were certain that intercessors would pray for them had a higher rate of complications than patients who were uncertain but did receive intercessory prayer.

Although our study population appears similar and representative of CABG patients in the United States,26 the proportion of patients in all 3 study groups who developed complications or major events

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    This study was supported by the John Templeton Foundation. The Baptist Memorial Health Care Corporation supported the Baptist Memorial Health Care Corporation site only.

    l

    Drs Benson, Dusek, and Hibberd contributed equally to this article.

    m

    Consultant to the Mind/Body Medical Institute.

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