Effect of a music intervention on anxiety in adult critically ill patients: a multicenter randomized clinical trial
Kakar E, Ottens T, Stads S, Wesselius S, Gommers DAMPJ, Jeekel J, van der Jagt M
Journal of intensive care · 14 citations
How it was studied
- Design
- Randomized controlled trial (classified by our AI screen)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- University or hospital
- Erasmus Medisch Centrum
- University or hospital
- Music as Medicine foundation, Erasmus MC, Rotterdam
Based on 2 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2023-08-17 · J Intensive Care · vol. 11 · issue 1 · p. 36
- Publisher
- BioMed Central
- Cited
- 20 citations · more than 96% of similar papers · 5.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 36 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Music Therapy and Health · Intensive Care Unit Cognitive Disorders · Family and Patient Care in Intensive Care Units
- Keywords
- Medicine, Anxiety, Randomized controlled trial, Delirium, Evening, Music therapy, Intensive care unit, Visual analogue scale, Sedation, Physical therapy, Anesthesia, Intensive care medicine, Internal medicine, Psychiatry
7 authors
From NL
- Ellaha Kakar · correspondingErasmus MC; Erasmus University Rotterdam
- Thomas H. OttensHaga Hospital
- Susanne StadsIkazia Ziekenhuis
- Sanne WesseliusHaga Hospital
- Diederik A M P J GommersErasmus MC; Erasmus University Rotterdam
- Johannes J. JeekelErasmus MC
Abstract
Background
Previous studies show positive effect of music on reducing anxiety, pain, and medication requirement. Anxiety has become a more pertinent issue in the intensive care unit (ICU) since wakefulness is preferred according to recent guidelines. Nevertheless, evidence on the effect of music in ICU patients is scarce. Therefore, we studied the effect of music intervention on anxiety in ICU patients.
Methods
A multicenter randomized clinical trial was conducted between August 2020 and December 2021 in ICU's at an academic medical centre and two regional hospitals. Adult critically ill patients were eligible when hemodynamically stable and able to communicate (Richmond agitation-sedation scale (RASS) of at least - 2). Patients in the intervention arm were offered music twice daily during three days for at least 30 min per session. Patients in the control group received standard care. The primary outcome was anxiety level assessed with the visual analogue scale for anxiety [VAS-A; range 0-10] twice daily (morning and evening). Secondary outcomes included; 6-item state-trait anxiety inventory (STAI-6), sleep quality, delirium, heart rate, mean arterial pressure, pain, RASS, medication, ICU length of stay, patients' memory and experience of ICU stay.
Results
94 patients were included in the primary analysis. Music did not significantly reduce anxiety (VAS-A in the intervention group; 2.5 (IQR 1.0-4.5), 1.8 (0.0-3.6), and 2.5 (0.0-3.6) on day 1, 2, and 3 vs. 3.0 (0.6-4.0), 1.5 (0.0-4.0), and 2.0 (0.0-4.0) in the control group; p > 0.92). Overall median daily VAS-A scores ranged from 1.5 to 3.0. Fewer patients required opioids (21 vs. 29, p = 0.03) and sleep quality was lower in the music group on study day one [5.0 (4.0-6.0) vs. 4.5 (3.0-5.0), p = 0.03]. Other outcomes were similar between groups.
Conclusions
Anxiety levels in this ICU population were low, and music during 3 days did not decrease anxiety. This study indicates that efficacy of music is context and intervention-dependent, given previous evidence showing decreased anxiety. Trial registration Netherlands Trial Register: NL8595, Registered, 1 April 2020.
Clinicaltrials
gov ID: NCT04796389, Registered retrospectively, 12 March 2021.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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