Music Therapy for Seniors at End-of-Life: Literature Review and a Preliminary Randomized Feasibility Study
*Corresponding author: Kirsten Davis*, Joanne Davidson, Alison Fraser and Helena Daudt
Music therapy (MT) is part of the care plan in many end-of-life (EOL) settings, though several authors remain cautious about its effectiveness to improve EOL symptoms and patient well-being.
Our primary goal was to design and test the feasibility of a clinical trial protocol that would address the main critiques of MT trials previously reported in the literature.
We conducted a literature review guided by the questions: (1) What is the set of indicators and tools that can be used to measure effectiveness of MT for seniors in palliative care and EOL settings? (2) What are the characteristics of a well-designed clinical trial protocol that can measure effectiveness of MT in palliative care and EOL settings and can be used for a future large scale study? Based on best practices from the review, we developed a clinical trial protocol and tested its feasibility.
Ten participants were accrued. Approximately 25% of eligible participants chose to participate. The consent rate was 55% with 70% of participants completing all MT sessions. All participants completed more than 60% of questionnaires.
Although our protocol could not be considered feasible based on the parameters we originally set, we argue that our study provides enough data to make adjustments to our original trial protocol, which could lead to the collection of reliable evidence related to the effectiveness of MT for seniors at EOL. We recommend future studies to use block randomization and allocation concealment, focus on one primary outcome and conduct intention-to-treat analysis.
Music Therapy (MT); End-of-Life (EOL); Seniors; Clinical trial; Palliative Performance Scale (PPS); Standardized Mini-Mental State Examination (SMMSE); Positive Affect and Negative Affect Schedule (PANAS); Spiritual Health Assessment (SHA).