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Table 3 Summary of study results for efficacy

From: Bach Flower Remedies for psychological problems and pain: a systematic review

Author, Year, Reference number Armstrong and Ernst 2001[18] Walach et. al. 2001[19] Pintov et. al. 2005[20] Halberstein et. al. 2007[3]
Country United Kingdom Germany Israel United States
Study design RCT Cross-over RCT RCT RCT
Risk of bias High (loss to follow up 55%) High (inadequate randomization) High (loss to follow up 42.5%) Low
Number of patients 100 61 40 111
Loss to follow-up 55% 9.8% 42.5% None
Study population Students with examination anxiety Students with examination anxiety registered to take at least two exams, two weeks apart Children with clinical diagnosis of any subtype of ADHD Nursing students with examination anxiety
Patient age (range and/or average, in years) Not reported 28 7–11 25.6 (18–49)
Indication for BFR Examination anxiety Examination anxiety ADHD Examination anxiety
Intervention 1–4 doses of Five Flower Remedy (Rescue Remedy) per day
Prunus cerasifera, Clematis vitalba, Impatiens glandulifera, Helianthemum and Ornithogalum umbellatum
At least 4 drops of a combination of 10 BFRs per day: Impatiens, mimulus, gentian, chestnut bud, rock rose, larch, cherry plum, white chestnut, scleranthus and elm 4 drops of five flower BFR 4 times per day: Prunus cerasifera, Clematis vitalba, Impatiens glandulifera, Helianthemum and Ornithogalum umbellatum Four drops of Rescue Remedy every 20 minutes over 3 hours: Prunus cerasifera, Clematis vitalba, Impatiens glandulifera, Helianthemum and Ornithogalum umbellatum
Control Placebo Placebo Placebo Placebo
Duration of treatment 7 days 4 weeks (two weeks before first exam and two weeks before second exam) 3 months 3 hours
Main outcome measures State-Trait Anxiety Inventory (STAI) German Test Anxiety Inventory (TAI-G) Conner's scale State-Trait Anxiety Inventory (STAI) for Adults, S-Anxiety subscale
Results No significant difference in State anxiety score (on the night before examination most likely to cause anxiety) between experimental and placebo groups – 51.5 in BFR group, 54.4 in placebo group (P = 0.834) No significant difference between experimental and placebo group for mean reduction in test anxiety: 5.25 in BFR group, 7.69 in placebo group (P = 0.55) No significant difference in mean Conner's scores between experimental and placebo group before (16.59 in BFR group, 17.12 in placebo group) or after (11.90 in BFR group, 13.58 in placebo group) treatment (P not reported). No significant difference in STAI S-Anxiety subscale between treatment and placebo groups.
  1. RCT : (randomised controlled trial)