Bradt, J., Potvin, N., Kesslick, A., Shim, M., Radl, D., Schriver, E., . . . Komarnicky-Kocher, L.T. (2015). The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: A mixed methods study. Supportive Care in Cancer, 23, 1261–1271. 

To compare the effects of music therapy and music medicine on pain and psychological outcomes, and to explore relevant patient experiences

Patients were randomly assigned to receive either two music therapy or two music medicine interventions during a two-week timeframe. After two weeks, subjects were crossed over to the other intervention. Music therapy was provided by a certified therapist and included a brief discussion of patients' concerns followed by the provision of live music based on assessed needs. Participants were invited to play an instrument, participate in breathing exercises, and express thoughts and emotions. Music medicine involved providing music based on preferences. Patients were asked not to engage in any other activity during listening. A blinded assessor interviewed patients after each music session and after the final session. Verbatim transcripts were analyzed by two coders to identify reported benefits or harms from descriptions of the experience.

• N = 31  
• MEAN AGE = 53.8 years (range = 32–88 years)
• MALES: 22.3%, FEMALES: 67.7%
• KEY DISEASE CHARACTERISTICS: Multiple tumor types with breast being most common
• OTHER KEY SAMPLE CHARACTERISTICS: 77% had high school or less education; 74.2% African American; 71% outpatient; and 29% inpatient

• SITE: Single site  
• SETTING TYPE: Multiple settings    
• LOCATION: Philadelphia, PA

• APPLICATIONS: Palliative care 

Single-blinded, randomized crossover trial

• 100 mm Visual Analog Scale (VAS) for mood and anxiety
• 11-point Numeric Rating Scale (NRS) for pain

Anxiety was reduced by 15 points with music therapy and 12 points with music medicine (p < 0.0001). There was no difference between the two conditions. Pain was reduced by 0.9–1.1 points (p < 0.0005) with no difference between the groups. Common themes from the qualitative analysis were experiencing the music as relaxing, peaceful, and soothing, and many patients appreciated the playful nature of interactive therapy sessions.

Both music therapy and listening to preferred music were associated with reductions in pain and anxiety.

• Small sample (< 100)
• Risk of bias (sample characteristics)
• Other limitations/explanation: The sample was predominantly African American. Although findings were statistically significant, the actual change in outcomes measured was small. Whether this level of change was clinically meaningful was not clear. VAS measurement for anxiety has questionable reliability. The context in which patients were involved was not stated, so there was no way to determine whether patients were in anxiety-producing situations.

Listening to music was shown to be as effective as music therapy provided by a therapist to assist in reducing pain and anxiety. Although the degree of change shown here was small and this study had several limitations, listening to music is a low-risk and simple intervention that may be beneficial to patients. Nurses should consider employing this technique with patients in anxiety-producing situations and as part of pain management.