Clinical significance of common cold treatment: professionals' opinions

Little is known about professionals' knowledge and attitudes regarding the clinical significance of treatments for common cold (upper respiratory infection, presumed viral).

We surveyed university-associated family physicians and published common cold researchers ("experts") regarding evidence-of-benefit and magnitude-of-benefit for 8 treatments: antihistamine, oral decongestant, nasal decongestant, nasal steroid, zinc lozenge, zinc nasal spray, vitamin C, and the herbal echinacea.

Responding family physicians (N = 89) and experts (N = 45) agreed that cold remedies do not reduce illness duration. There was substantial disagreement, however, regarding the evidence for severity reduction. Decongestants were rated most favorably. Alternative therapies (zinc, vitamin C, and echinacea) were rated approximately as favorably as the other conventional treatments (antihistamine, decongestant, nasal steroid). Published experts and family physicians responded similarly, as did men (N = 84) and women (N = 49). Older respondents (age > or = 45; N = 67) were less likely to rate treatments as justifiable than were their younger counterparts (P-values ranged from 0.001 to 0.078).

Family physicians and common cold experts tend to agree that available cold remedies offer limited benefit, with conventional and alternative therapies rated similarly. Substantive disagreements exist, however, regarding strength-of-evidence, and over whether current evidence justifies treatment. Older professionals appear more skeptical.