Enhancing Hybrid Music Therapy for Cardiac and Pulmonary Patients

A recent study conducted by University Hospitals Connor Whole Health has demonstrated the feasibility of implementing a hybrid music therapy intervention for individuals suffering from heart failure and chronic obstructive pulmonary disease (COPD). Participants of the study reported improvements in mental health, and the pilot program highlighted potential enhancements for future research within this patient demographic. The findings were published in the journal BMC Complementary Medicine and Therapies.

Patients with chronic ailments such as heart failure and COPD often experience significant difficulties due to ongoing symptoms, including breathlessness, fatigue, and limited physical capability. Additionally, mental health issues, including anxiety and depression, are prevalent in this group, increasing the risk of hospital readmissions. Such readmissions pose challenges not only for patients but also for healthcare facilities, which may incur financial penalties due to these occurrences.

Recognizing the psychosocial factors contributing to the risk of 30-day readmissions, and the scarcity of research examining the effects of music therapy on readmission rates and quality of life, the research team from UH Connor Whole Health initiated a two-year project titled Music Therapy to Address patients' JOurneys with CHronic illness, Outcome, and ReaDmission (MAJOR CHORD). This project aims to fill a significant gap in the current music therapy literature.

According to the lead researcher, the immediate benefits of music therapy during hospital admissions are well-documented, but there is a lack of evidence regarding its long-term effects on patient health and its potential to reduce costly readmissions. This study serves as a foundational framework for understanding how music therapy can be effectively administered and evaluated.

The primary aim of the pilot study was to assess whether it was viable to deliver music therapy sessions consistently, both in hospital settings and through virtual means after discharge, while also enabling participants to complete various assessments throughout the study duration. The research team also sought to identify necessary modifications to the intervention and data collection methods before embarking on a larger randomized controlled trial.

During the study, participants diagnosed with heart failure or COPD were recruited during their hospital stays. Licensed music therapists facilitated two in-person sessions during their admission, followed by two virtual sessions after discharge. Participants were asked to complete assessments measuring stress, quality of life, and self-efficacy at three points: upon enrollment, 15 days post-discharge, and 30 days post-discharge. Some participants also participated in interviews at the conclusion of the study to share their experiences and feedback regarding the intervention.

Despite being a preliminary pilot, the study yielded promising results, while also identifying areas for improvement in data collection and participant attendance. Out of 113 potential candidates approached, 20 individuals enrolled in the study, resulting in a retention rate of 85%. Overall attendance for sessions was recorded at 57.5%, with higher participation rates in the in-person sessions (75%) compared to virtual sessions (40%). Compliance with the intervention protocols exceeded 80% across all monitored sessions, indicating a high degree of fidelity in the study's execution.

Interviews conducted with participants revealed three key themes regarding the intervention's acceptability: the establishment of a therapeutic rapport enhanced their experience, the necessity for strategies to boost post-discharge participation, and the positive effects on mental health.

Challenges encountered during the trial included difficulties in reaching participants after discharge, frequent rescheduling of virtual sessions, and technological barriers faced by some participants. In response, the research team is implementing follow-up studies, including a randomized controlled trial that compares music therapy with standard care.

To address the issues identified in the pilot study, the team has introduced solutions such as secure text messaging to improve communication, in-person technical support for videoconferencing, and increased follow-up interactions with participants after discharge.

In conclusion, the initial findings indicate that a four-session hybrid music therapy intervention is feasible and acceptable for adults with COPD and heart failure during and after hospitalization. This research lays the groundwork for future investigations into the long-term effects of music therapy on quality of life and hospital readmission rates.