Key points Ask Are music listening and making interventions associated with positive changes in health-related quality of life? Findings This systematic review and meta-analysis of 26 studies including 779 people found that music interventions were associated with statistically and clinically significant changes in mental HRQOL, both before and after the intervention, as well as when music interventions were added to treatment as usual. compared to usual treatment in control groups Meaning These results suggest that associations between music interventions and clinically significant changes in HRQoL are demonstrable in comprehensive reviews of previous studies. |
Importance
There is increasing evidence supporting music’s ability to broadly promote well-being and health-related quality of life (HRQoL). However, the magnitude of music’s positive association with HRQoL remains unclear, particularly in relation to established interventions, limiting the inclusion of music interventions in policy and health care.
Aim
To synthesize results from studies investigating the outcomes of music interventions in terms of HRQoL, as assessed by the 36- and 12-item Short Form Health Survey (SF-36 and SF-12).
Data sources
MEDLINE, Embase, Web of Science, PsycINFO, ClinicalTrials.gov, and International Clinical Trials Registry Platform (search July 30, 2021, no restrictions).
Study selection
Inclusion criteria were randomized, single-arm studies of music interventions that reported SF-36 data at pre- and post-intervention time points. Observational studies were excluded. The studies were reviewed independently by 2 authors.
Data extraction and synthesis
Data were independently extracted and assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations) criteria by multiple authors.
Inverse-variance random-effects meta-analyses quantified changes in SF-36 mental and physical component summary scores (MCS and PCS, respectively) from preintervention to postintervention and versus common control groups. .
Results
Analyzes included 779 participants from 26 studies (mean [SD] age, 60 [11] years). Musical interventions (listening to music, 10 studies; music therapy, 7 studies; singing, 8 studies; gospel music, 1 study) were associated with significant improvements in MCS scores (overall mean difference, 2.95 points; 95% CI). , 1.39-4.51 points; P < 0.001) and PCS scores (total mean difference, 1.09 points; 95% CI, 0.15-2.03 points; P = 0.02).
In subgroup analysis (8 studies), adding music to standard treatment for a variety of conditions was associated with significant improvements in MCS scores versus standard treatment alone (mean difference, 3.72 points; 95% CI). %, 0.40-7.05 points; P = .03).
Effect sizes did not vary between types or doses of music intervention; There was no evidence of small study or publication bias in any analysis. The mean difference in MCS scores met the SF-36 minimum significant difference thresholds (mean difference 3 or more).
Conclusions and relevance
In this systematic review and meta-analysis, music interventions were associated with clinically significant improvements in HRQoL; however, substantial individual variation in intervention outcomes precluded conclusions regarding music interventions and optimal doses for different clinical and public health settings.
Comments
Many believe that musical interventions of various types are associated with health-related benefits, but the heterogeneity of such interventions (and the perceived difference in the magnitude of benefit) makes it difficult for clinicians to know how to use music effectively.
The researchers conducted a meta-analysis of randomized and non-randomized studies of any music intervention and identified 26 eligible studies that were conducted in 13 countries with almost 800 participants in total. All studies used physical, mental, or both component scores of the SF-36, a validated health-related quality of life (HRQoL) instrument.
The studies primarily involved clinical populations (e.g., patients with chronic pain, cardiovascular disease, or cancer) rather than healthy patients. The interventions were listening to music (10 studies), music therapy (7), singing (8), and gospel music (1); Music therapy was defined as the structured use of musical interventions within a therapeutic professional relationship.
Various types of controls were used, including usual care and meditation. Interventions were administered 1 to 7 times per week and duration was 6 to 12 weeks. Significant positive changes were observed in physical and mental HRQOL scores of participants who received music interventions compared to controls. The magnitude of change generally did not vary by intervention type.
The authors concluded that music interventions have HRQoL benefits of a similar magnitude ("although on the lower end") to many other interventions, both pharmaceutical and non-pharmaceutical.
At a minimum, clinicians can support a variety of musical interventions that patients may request or have made available.
