Music Therapy Plus Analgesia Reduces Pain and Anxiety Among Patients in the ED

Music therapy in combination with conventional analgesia effectively reduces pain and anxiety among patients in the emergency department (ED), especially for those with nontrauma pain, according to study results published in International Journal of Emergency Medicine.

The use of music therapy to reduce pain and improve patient satisfaction in the ED has not been fully explored. In a single-center, randomized controlled trial, researchers studied the effect of music therapy on pain and anxiety in patients in the ED.

Eligible participants presented to the ED with self-reported pain, could communicate verbally, had stable vital signs, and completed an initial evaluation by the ED providers.

All participants received analgesic treatment, followed by a pre-test questionnaire to gather information on baseline pain scores, anxiety, satisfaction, and ED quality assessments. Music therapy sessions were conducted by music therapists within the ED. A post-test questionnaire was also administered 1 hour after analgesia and the music therapy session. A control group was also included in the study who received analgesia in the ED, following which the participants completed the pre- and post-test questionnaires. 

The questionnaires included information about patient characteristics and parameters such as pain, anxiety, patient satisfaction, and ED quality, all of which were rated on a scale of 0 to 10 (0 representing no pain).

The primary outcome of the study was difference in pain scores before and after analgesia in both groups, and music therapy in the intervention group. Secondary outcomes included difference in anxiety, satisfaction, and ED quality scores before and after analgesia in both groups.

A total of 63 patients (mean age, 58.2 years; women, 61.6%) were included in the study, of whom 31 were assigned to the music-therapy group and the remaining 32 to the control group. The most frequently used analgesic in both groups was opioids (14.2%), with the most common cause for pain being nontrauma-related (60.3%).

The researchers noted a significant difference in pain score reduction between the 2 groups (P =.002) — participants in the music-therapy group had a pain reduction score of 1.52 points (5.58 points presession to 4.06 points postsession) and those in the control group had a pain reduction score of 0.09 (5.22 points presession to 5.13 points postsession).

Differences in pain reduction was more pronounced among participants with nontrauma- vs trauma-related pain (P <.001). In the music-therapy vs control group, pain reduction scores of 2.20 (5.50 to 3.30) vs 0.22 (5.61 to 5.39) points, respectively, were observed.

In addition, presession vs postsession anxiety differed between the groups (P =.026), with participants in the music-therapy vs control group showing a greater reduction in pain (1.87 vs 0.44 point-decrease, respectively).

Differences in pain reduction were more pronounced in participants with nontrauma- vs trauma-related pain (P =.019), with a reduction in 2.35 vs 0.50 points in the music-therapy vs control group, respectively.

While patient satisfaction scores were similar between the groups, quality of ED service scores were statistically significantly different. Participants in the music-therapy vs control group reported a higher increase in scores (0.98 vs 0.10 points, respectively).

Study limitations included the single-center design, the small sample size, and the lack of blinding participants and healthcare providers may have introduced a bias.

Overall, the researchers noted, “[Music therapy] can enhance service quality and treatment of pain in the ED.”