CLEVELAND – A new study from University Hospitals Connor Whole Health found that it was feasible to conduct a hybrid music therapy intervention for patients with heart failure and patients with chronic obstructive pulmonary disease (COPD). Participants reported positive effects on their mental health, and the pilot uncovered solutions to improve future research with this population. The findings from this study were recently published in BMC Complementary Medicine and Therapies.
Patients with chronic illnesses such as heart failure and COPD face significant challenges due to persistent symptoms like shortness of breath, fatigue, and reduced functional capacity. Mental health conditions and self-reported symptoms of depression and anxiety are also common in this population and can increase patients' risk of readmission to the hospital. These readmissions are not only hard for patients – they are also challenging for hospitals that face financial penalties when patients with these conditions are readmitted.
Given the psychosocial factors driving risk for 30-day admission, the lack of studies investigating music therapy's impact on readmission and quality of life, and the critical importance for hospitals to reduce readmission rates, researchers from UH Connor Whole Health embarked on a two-year research project entitled Music Therapy to Address patient's JOuRneys with CHronic illness, Outcome, and ReaDmission (MAJOR CHORD) to address this major gap in music therapy research.
"We know that music therapy has an immediate and profound impact on patients' symptoms when they are admitted to the hospital, but few studies have examined if we can go beyond those single-session effects to address patients' long-term health and help prevent costly re-admissions," said Samuel Rodgers-Melnick, MPH, LPMT, MT-BC , a researcher with UH Connor Whole Health and Principal Investigator of the study. "This study provides a roadmap for how we can provide these interventions and collect data to understand music therapy's impact."
With support from the Kulas Foundation, the country's leading foundation for funding scientific research in music therapy, MAJOR CHORD is the first research initiative to investigate the feasibility, fidelity, and acceptability of a hybrid music therapy intervention among patients with COPD or heart failure. The Kulas Foundation has a long history of funding pioneering research at UH on the impacts of music therapy in palliative care , breast biopsy surgery , sickle cell disease , and hospitalized patients with moderate-to-severe pain .
The goal of the pilot was to establish a foundation for future definitive trials by determining whether it was possible to deliver music therapy sessions consistently – both in-person in the hospital and virtually at home – and have participants complete survey measures over the course of the study. The investigators also sought to determine which modifications (if any) would need to be made to the intervention and data collection processes prior to initiating a feasibility randomized controlled trial. Assessing the feasibility, acceptability, and fidelity of a study prior to conducting larger trials is crucial to ensure future research efforts will be successful and internally valid. Through monitoring each music therapy session's compliance with a checklist, the investigators also ensured that the trial was conducted with high fidelity.
During the study, participants with heart failure or COPD were recruited while they were admitted in the hospital. Board-certified music therapists conducted two in-person music therapy sessions while the participants were admitted. After participants were discharged, they then received two virtual music therapy sessions. Participants completed measures of stress, quality of life, and self-efficacy at baseline, 15 days after they left the hospital, and 30 days after they left the hospital. Some participants also completed an interview at the end of the study to provide feedback on study procedures and how the intervention may have affected them.
As an initial pilot, the study yielded encouraging results while also demonstrating the need to improve data collection procedures and attendance. Of 113 patients approached, 20 were enrolled in the study (17.7%), with an 85% retention rate throughout the study. Overall session attendance was 57.5%, with higher rates for in-person (75%) compared to virtual sessions (40%). Adherence to the intervention protocol was >80% across all monitored sessions – a threshold consistent with high fidelity. Semi-structured interviews supported the acceptability of the intervention with three emerging themes: (1) the therapeutic relationship facilitated a positive intervention experience, (2) need for strategies to improve post-discharge engagement in the intervention, and (3) impacts on mental health.
Challenges with the trial included difficulty reaching participants following discharge, frequent virtual session rescheduling, and participants' challenges using technology. The research team is currently conducting their follow up study – a randomized controlled trial comparing music therapy to usual care. To address the challenges encountered in the pilot, the team implemented solutions including (1) secure text-messaging with participants to improve communication, (2) in-person technical assistance to help participants with videoconferencing, and (3) engaging in more frequent communication with participants following discharge.
Overall, preliminary findings support the feasibility and acceptability of a 4-session hybrid music therapy intervention among adults with COPD or heart failure during and after their hospital admissions. The results of this study help lay the foundation for future research on the impact of longitudinal music therapy exposure on quality of life and hospital readmission rates.
"Hybrid music therapy shows promise in supporting patients with COPD and heart failure, enhancing engagement and mental health, though challenges in virtual care post-discharge need further refinement." said Kristi Artz, MD, FACLM, CCMS , Vice President of Connor Whole Health.
You can read the article, "Refining a Hybrid Music Therapy Intervention for Chronic Obstructive Pulmonary Disease and Heart Failure: A Single Arm Pilot Study" by clicking here .
Reference:
Yu H, Foss A, Segall TL, Block S, Risser K, Razzak R, Zacharias M, Teba CV, Rodgers-Melnick SN. Refining a hybrid music therapy intervention for chronic obstructive pulmonary disease and heart failure: a single arm pilot study. BMC Complement Med Ther. 2025;25(1):139. doi: 10.1186/s12906-025-04887-x.
