Music Interventions and Delirium in Adults: A Systematic Literature Review and Meta-Analysis

Jelena Golubovic, Bjørn Erik Neerland, Dagfinn Aune, Felicity A Baker, Jelena Golubovic, Bjørn Erik Neerland, Dagfinn Aune, Felicity A Baker

Abstract

Delirium is a neuropsychiatric syndrome represented by an acute disturbance in attention, awareness and cognition, highly prevalent in older, and critically ill patients, and associated with poor outcomes. This review synthesized existing evidence on the effectiveness of music interventions on delirium in adults, and music interventions (MIs), psychometric assessments and outcome measures used. We searched MEDLINE, PsychINFO, SCOPUS, Clinical Trials and CENTRAL for quantitative designs comparing any MIs to standard care or another intervention. From 1150 studies 12 met the inclusion criteria, and 6 were included in the meta-analysis. Narrative synthesis showed that most studies focused on prevention, few assessed delirium severity, with the majority of studies reporting beneficial effects. The summary relative risk for incident delirium comparing music vs. no music in postsurgical and critically ill older patients was 0.52 (95% confidential interval (CI): 0.20−1.35, I2 = 79.1%, heterogeneity <0.0001) for the random effects model and 0.47 (95% CI: 0.34−0.66) using the fixed effects model. Music listening interventions were more commonly applied than music therapy delivered by credentialed music therapists, and delirium assessments methods were heterogeneous, including both standardized tools and systematic observations. Better designed studies are needed addressing effectiveness of MIs in specific patient subgroups, exploring the correlations between intervention-types/dosages and delirium symptoms.

Keywords: acute confusion; delirium; meta-analysis; music interventions; music therapy; prevention; systematic review; treatment.

Conflict of interest statement

The authors declare no conflict of interest. This work was supported by the Norwegian Academy of Music (NMH), and through the PhD fellowship position of Jelena Golubovic. The work is a part of Jelena Golubovic’ s PhD project, for which Prof. Felicity Baker, also affiliated to the Norwegian Academy of Music, is the main supervisor. NMH was not otherwise involved with the design and conduct of this work.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Music exposure and delirium incidence (random effects meta-analysis) [31,33,34,36,38,42].

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