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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)