CLEVELAND – A new study from University Hospitals (UH) Connor Whole Health found patients with moderate-to-severe pain, stress, or anxiety treated at UH community hospitals reported clinically significant reductions in pain, stress, and anxiety in response to a single session of music therapy. Furthermore, the clinically significant effect on pain was not influenced by patients’ demographic or clinical characteristics, suggesting that music therapy can be effective for acute pain management across various inpatient adult populations. The findings from this study were recently published in the journal, Pain Reports, a leading journal focusing on advancing pain research.
In this retrospective study conducted between January 2017 and July 2020, researchers from UH Connor Whole Health examined the first music therapy interventions provided to 1,056 adults receiving inpatient medical care who reported pre-session pain, anxiety, and/or stress scores greater than or equal to 4 on the 0 to 10 numeric rating scale. Unlike prior studies of music therapy, which have primarily been conducted at academic medical centers, this is the first and largest investigation of the real-world effectiveness of music therapy within community medical centers. This study builds upon a history of seminal music therapy studies funded by the Kulas Foundation, the country’s leading foundation for funding scientific research in music therapy, that have investigated the efficacy of music therapy in palliative care, surgery, and sickle cell disease as well as the clinical effectiveness of music therapy within an academic cancer center.
“The music therapists at UH Connor Whole Health offer non-pharmacological frontline treatment throughout our medical system while addressing issues of stress, pain, and anxiety. Greater Cleveland residents may receive these services during hospitalizations at UH as a clinical service line offering direct evidence-based community benefit,” said Seneca Block, The Lauren Rich Fine Endowed Director of Expressive Therapies at UH Connor Whole Health. UH Connor Whole Health manages the largest health system-based music therapy program in the US with 11 board-certified music therapists who collaborate with providers across the system to help patients and their families manage the physical and emotional toll of an illness or hospitalization. Additionally, UH Connor Whole Health provides a diverse offering of integrative health and medicine modalities, including acupuncture, chiropractic, and integrative medicine consults, that are centered on patients’ entire well-being.
In “Effectiveness of Music Therapy within Community Hospitals: An EMMPIRE Retrospective Study,” researchers examined the real-world effectiveness of music therapy at eight UH community medical centers and explored variables associated with pain reduction of greater than or equal to 2 units on a 0 to 10 unit numeric rating scale.
Music therapists provided interventions including live music listening, music-assisted relaxation and imagery, and active music making to address patients’ needs including pain management, coping, stress reduction, and anxiety reduction. As part of clinical care, the music therapists assessed patients’ self-reported pain, stress, and anxiety on a 0 to 10 scale at the beginning and end of each session and documented their sessions in the electronic health record.
“What makes this research novel is our ability to streamline data collection from music therapy clinical practice to the electronic health record. We can then use these data to understand the real-world impact of music therapy throughout multiple medical centers and how best to tailor music therapy interventions to meet patients’ needs,” said Sam Rodgers-Melnick, a music therapist, first author of the study, and a co-investigator on the EMMPIRE project (Effectiveness of Medical Music Therapy Practice: Integrative Research using the Electronic Health Record). The present EMMPIRE study was funded by a 3-year grant from the Kulas Foundation to UH Hospitals.org/ConnorWholeHealth with Jeffery A. Dusek PhD, Director of Research, UH Connor Whole Health, Block and Rodgers-Melnick as prime investigators. Said Dusek, “Routine collection of patient-reported outcomes from clinical practice (also called practice-based research) is becoming increasingly common as a patient-centered quality of care measure.”
Prior research has demonstrated that reductions of at least 1.3 units on the numeric rating scale for pain are clinically significant for patients with non-cancer pain, meaning that the symptom reduction represents a meaningful difference for patients with moderate-to-severe symptoms. Reductions of at least 2 units in stress and anxiety are also considered clinically significant. In this study, patients reported clinically significant mean reductions in pain (2.04 units), anxiety (2.80 units), and stress (3.48 units) in response to music therapy, with all changes exceeding clinically significant thresholds. Additionally, of the patients reporting a pain score greater than or equal to 4, 14% fell asleep during music therapy sessions, an important observation given the sleep challenges patients with moderate-to-severe pain face during hospitalization.
Additionally, after adjusting for demographic, clinical, and operational characteristics, patients receiving a music therapy session in which pain management was a goal were 4.32 times more likely to report pain reduction greater than or equal to 2 units than patients receiving a music therapy session in which pain management was not a session goal. Said Rodgers-Melnick, “this finding raises important questions regarding how music therapists tailor their interventions to address pain when that is the goal of the session, and we will be examining these specific features of music therapy interventions in future research.
“Music therapy provides an alternative but very effective mechanism for managing a patient’s discomfort,” explained Donald DeCarlo, MD, MBA, Chief Medical Officer of UH East Market.
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About UH Connor Whole Health
UH Connor Whole Health is part of University Hospitals (UH), a comprehensive health system with annual revenues in excess of $5.0 billion, 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices located throughout 16 counties. UH’s goal is to be the most trusted health care partner in Northeast Ohio and UH Connor Whole Health furthers this objective by working to strengthen relationships between patients and providers to improve outcomes. The Whole Health approach prioritizes compassionate care centered on the patient’s entire well-being. The health care provider’s goal is to equip and empower each patient to take charge of their physical, mental, and spiritual health in order to live a full and meaningful life. Linking the patient’s larger purpose and life goals to their lifestyle allows clinical services, integrative medicine, and well-being programs to be delivered in a way that increases collaboration, motivation, and adherence to self-care and clinical needs. UH Connor Whole Health services include acupuncture, art therapy, chiropractic, expressive therapy (art, dance, and music), guided imagery, integrative medicine/lifestyle medicine consultations (adult and pediatric), massage therapy, meditation, mindfulness, osteopathic sports rehabilitation, stress management and resilience training workshops and yoga. For more information, visit UH Hospitals.org/ConnorWholeHealth. Follow UH Connor Whole Health on LinkedIn.
About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.
Journal
PAIN Reports
Article Title
Effectiveness of Music Therapy within Community Hospitals: An EMMPIRE Retrospective Study