Developing Real-world Understanding of Medical Music therapy using the Electronic Health Record (DRUMMER) - Enter the text here that is the new abstract information for your application. This section must be no longer than 30 lines of text. Several randomized controlled trials (RCTs) support the efficacy of music therapy (MT) for improving pain and symptom management among several patient populations including cancer, sickle cell disease, and orthopedic surgery. MT is the clinical use of tailored music interventions (e.g., active music making and music-assisted relaxation) to accomplish individualized goals within a therapeutic relationship by a credentialed professional (i.e., board-certified music therapist). Despite evidence for MT’s efficacy from RCTs and the increased delivery of MT in clinical settings, few clinical effectiveness studies have evaluated the real-world impact of MT within health systems. Evaluating integrative pain management approaches such as MT is a vital need, especially as health systems seek effective nonpharmacologic pain management solutions to reduce risks stemming from opioid use. Substantial gaps remain in understanding MT’s clinical effectiveness. These include: 1) identifying socio-demographic, clinical, and MT intervention characteristics associated with changes in patient-reported outcome measures (PROMs); 2) comparing outcomes (e.g., medication use and length of stay) between patients receiving MT and similar patients receiving usual care; and 3) examining longitudinal effects on PROMs beyond the initial MT session. Using a large electronic health record (EHR) dataset of 31,359 MT sessions provided to 15,460 patients (mean age 63.6 years, 33.5% Black/African American) across 20,405 hospital admissions, I propose applying regression models, propensity-score matching, and longitudinal mixed effects models to examine the clinical effectiveness of MT. My Specific Aims are: AIM 1) investigate which socio-demographic characteristics (e.g., age, sex, insurance status, and income), clinical characteristics (e.g., diagnoses and care setting), and/or MT session characteristics (e.g., length and MT interventions utilized) are associated with changes in PROMs (i.e., 0-10 measures of stress, pain intensity, anxiety, and coping); AIM 2) compare outcomes including length of stay, medications administered for pain and anxiety, and longitudinal pain intensity scores between inpatients receiving MT and propensity-score matched controls; and EXPLORATORY AIM 3) examine longitudinal effects on PROMs over the course of hospital admissions among patients receiving MT. This proposal will provide the applicant with foundational knowledge and experience needed to conduct future practice-based clinical effectiveness research not only in MT, but across multiple integrative therapies (e.g., acupuncture and massage therapy) deployed within health systems. As health systems develop EHR-based quality improvement tools and implement nonpharmacologic pain modalities, the skills acquired within this proposal will be especially important for understanding the real-world impact of integrative health and medicine modalities and improving evidence-based patient care.
