Music Therapy as a Treatment for Delirium in Acutely Hospitalized Older Patients

University of Oslo (UIO)

Status: Completed

Conditions: Delirium Confusional State; Delirium Superimposed on Dementia; Delirium in Old Age; Delirium of Mixed Origin

Treatments: Behavioral: Preferred Recorded Music (PRM); Behavioral: Preferred Live Music (PLM)

Study type: Interventional

Funder types: Other

Identifiers

NCT05398211

REK 457017

Details and patient eligibility

About

The purpose of this study is to assess feasibility and potential effectiveness of two different music interventions for managing delirium symptoms in acute geriatric patients.

Full description

Delirium is a neuropsychiatric syndrome characterized by an acute alteration in attention, awareness, arousal and cognition, precipitated by an acute illness, intoxication, trauma or surgery. It is highly prevalent in older, frail and acutely hospitalized patients, and associated with poor outcomes, with few effective treatment alternatives. Non-pharmacological interventions and music show promising effects.

This study protocol aims to determine whether music interventions (MIs) delivered by a credentialed music therapist, are feasible and effective for regulating delirium symptoms in acute geriatric patients and whether the standardized delirium tools are sensitive to detect observable responses. Primary, feasibility outcomes are evaluating recruitment rate, treatment fidelity and adherence, as well as feasibility and accuracy in data collection procedures. Main effect-outcome is delirium severity, but delirium duration, cognitive status, length of hospital stay, and medication use will also be recorded. The randomised repeated measures controlled trial design will record the participant responses before and after exposure to MIs (+/- 2 hours). Participants with delirium from an acute geriatric ward will be randomized to either live or recorded MI. Each intervention will be delivered to n=30 participants (n=60 in total), for 30 minutes, over three consecutive days. Ethical approval has been obtained from Regional Ethics Committee South East Norway.

Enrollment: 26 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged ≥ 65 and with delirium or possible delirium at admission or detected within the last 72 hours, and still present.
• Appropriate informed consent is obtained.
• Participants will not be excluded if they are under long term care and have comorbidities such as dementia or mild cognitive impairment.
• Patients will not be excluded if they have Covid-19.

Exclusion criteria

• Patients who were previously enrolled, and were readmitted during the study period will not be re-included.
• The patients with severe hearing impairments, severe psychiatric conditions, and/or severe alcohol/substance addiction where that is the main reason for admission will be excluded.
• The patients whose assessed musical preferences involve orchestral or other kinds of music which cannot be performed live by voice and a guitar.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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26 participants in 2 patient groups

Preferred Recorded Music (PRM)

Experimental group

Description:

The Preferred Live Music (PLM) aims to elicit participants' responses from live music and the ensuing musical and non-musical interactions with the music therapist (MT). In the PLM intervention, preferred songs performed live on guitar or electronic keyboard will be played by a credentialed MT. When appropriate participants may also play percussion instruments offered to them. Elements of improvisation will be incorporated to allow for active engagement by the participants, and to provide opportunities for musical and non-musical attunement to emerge.

Treatment:

Behavioral: Preferred Recorded Music (PRM)

Preferred Live Music (PLM)

Experimental group

Description:

The Preferred Recorded Music (PRM) intervention aims to detect responses directly attributable to the music. Participants listen to pre-recorded preferred originally-published versions of music accessed by Spotify music-streaming service and played through loud-speakers. The MT will only start the music, and otherwise not be present during the interventions to ensure the minimal direct interaction with the participants.

Treatment:

Behavioral: Preferred Live Music (PLM)