CLEVELAND – A new study from University Hospitals Connor Whole Health found that music therapy interventions involving singing, active instrument play, and relaxation/imagery may be more effective for reducing pain intensity than receptive interventions only involving live or recorded music listening among hospitalized patients with moderate-to-severe pain. The findings from this study were recently published in The Journal of Pain .
Within every hospitalization, most patients will experience elevated acute pain at some point during their stay. If this pain is not well-managed, patients may experience significant psychological distress and decreased functioning following hospital discharge. Given the risk of addiction and other adverse events associated with opioid pain medications, many health systems are turning toward evidence-based nonpharmacologic approaches such as music therapy to help optimize pain management.
"Our team of licensed professional music and art therapists are embedded throughout the hospital system, collaborating with physicians, nurses, and other allied health professionals to help manage patients' symptoms and enhance psychosocial support," said Seneca Block, PhD, LPMT, MT-BC , the Lauren Rich Fine Endowed Director for Expressive Therapies with UH Connor Whole Health. Block leads the largest hospital-based expressive therapies programs in the country , with 12 music therapists, 5 art therapists, and several interns embedded throughout 10 medical centers in the UH health system.
While several studies support music therapy's benefits for reducing acute pain, few have examined which interventions are most effective or which patients are more likely to respond. To fill this gap in research, Samuel Rodgers-Melnick, PhD, MPH, LPMT, MT-BC , principal investigator and lead author of the study, analyzed data from more than 2,000 music therapy sessions among patients with moderate-to-severe pain to examine which sociodemographic, clinical, and intervention characteristics are associated with clinically significant reductions in pain intensity (0-10 numeric rating scale reduction ≥2 units) within a single music therapy session. This work builds upon Rodgers-Melnick's prior retrospective studies of electronic health record data supported by the Kulas Foundation , a leading private foundation in Cleveland, Ohio dedicated to advancing scientific research in music therapy.
Rodgers-Melnick and the research team compared four distinct categories of music therapy interventions: (1) Receptive only, where the music therapist engaged patients with live or recorded music listening, but the patient did not engage in any active music making, composition, or relaxation/imagery techniques; (2) Recreative, where the patient engaged in some instrument play or singing along with live or recorded music, but no composition techniques; (3) Music-assisted relaxation and imagery where the patient did not engage in instrument play, singing, or composition, but did engage in relaxation/imagery techniques along with live or recorded music; and (4) Compositional/creative, where the patient engaged in some sort of composition (i.e., songwriting, song dedication, music-assisted life review, or song recording).
This investigation required curating the largest dataset of medical music therapy practice ever assembled – a process that involved extracting millions of data points related to patients' demographics, diagnoses, medications, and health services from the UH electronic health record.
"At UH Connor Whole Health, we believe the real-world data we generate from clinical care can be used to refine our approaches, improve patient outcomes, and help other health systems do the same," said Kristi Artz, MD, MS, FACLM, CCMS , Vice President of UH Connor Whole Health and Sara H. Connor Chair in Integrative Health.
After accounting for differences in sociodemographic and clinical characteristics, recreative music therapy interventions were 37 percent more likely, and music-assisted relaxation and imagery interventions were 48 percent more likely, to result in pain intensity reduction ≥2 units than receptive only interventions, respectively. Additionally longer music therapy sessions and those documented with an explicit goal of managing pain were more likely to reduce pain ≥2 units. By contrast, male patients, Medicaid beneficiaries, and patients with sickle cell disease were less likely to report pain reduction ≥2 units within the analysis.
"These findings support the unique role music therapists provide in engaging patients in singing, instrument play, relaxation, breathwork, and imagery within music interventions to manage pain," said Rodgers-Melnick. "There's something special happening when we engage patients in the musical process that should inform how music therapists practice, how hospitals implement music therapy services, and how future researchers examine mechanisms of action."
You can read the article, "Impact of sociodemographic, clinical, and intervention characteristics on pain intensity within a single music therapy session" by clicking here .
