Surgical patients with mental health conditions who receive music therapy are more medically complex, study finds
by University Hospitals Cleveland Medical Center
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A new study from University Hospitals Connor Whole Health found that patients with mental health and/or substance use disorders who undergo surgery and receive music therapy are more medically complex and therefore may experience longer hospital stays compared to other patients receiving usual care. The findings from this study were recently published in the Journal of Integrative and Complementary Medicine.
Patients with mental health and/or substance use disorders often experience multiple adverse outcomes, including increased length of stay, cost, and mortality rates. These patients often have worse pain management, with increased postoperative pain and duration, which increases their risk of developing opioid use disorder. Considering the risk of adverse events associated with opioid use, many health systems are choosing to shift from opioid-centered pain management to evidence-based nonpharmacologic treatments such as music therapy.
Sam Rodgers-Melnick, Ph.D., MPH, LPMT, MT-BC led a series of studies leveraging electronic health record data to investigate music therapy's real-world impact at UH. These studies demonstrated how music therapy can be integrated throughout a large health system; the clinically meaningful impact of a single music therapy session for addressing pain, stress, anxiety, and fatigue among patients receiving care at an academic cancer center and patients with moderate-to-severe symptoms receiving treatment at eight UH community hospitals; and a quality improvement initiative to increase patient-reported outcome collection among a medical music therapy team.
Building off that prior work and with support from the National Center for Complementary & Integrative Health, Dr. Rodgers-Melnick examined characteristics associated with receiving music therapy and the impact of music therapy on length of stay and opioid utilization among patients with mental health and/or substance use disorders admitted for surgery. The retrospective study compared patients receiving 2-10 music therapy interventions with patients who did not receive such treatment using data from the UH electronic health record.
After accounting for differences in sociodemographic and clinical characteristics, surgical patients with mental health and/or substance use disorders who received music therapy were more medically complex and had a 41.8% longer length of stay at the hospital compared to a matched control group. Additionally, receiving a median of 3 music therapy interventions across 18.18% of admitted hospital days was not associated with a meaningful reduction in opioid utilization. Patients who received music therapy were more likely to have anxiety, trauma/stress-related disorders, heart failure, higher early opioid exposure by 48 hours of admission, and receive palliative care. These patients also had more resource-intensive admissions.
"Improving patient outcomes including hospital length of stay and opioid exposure for chronic pain are important targets for whole health interventions. A greater understanding of patient factors which may influence outcomes is necessary for these interventions to have the desired impact," said Kristi Artz, MD, MS, Vice President of University Hospitals Connor Whole Health and the Christopher M. and Sara H. Chair in Integrative Health.
This is the first study to demonstrate that compared to surgical patients not receiving music therapy, those who do receive music therapy have larger comorbidity burden, a factor which also contributes to prolonged length of stay. Findings related to music therapy's impact should be interpreted with caution given the increased comorbidity burden observed among patients receiving music therapy and the inability to account for various factors that contribute to increased length of stay.
Receiving music therapy interventions on less than 20% of a patient's days admitted to the hospital does not appear to have a meaningful impact on opioid utilization within this population. However, findings inform clinical factors (e.g., anxiety, trauma/stress-related disorders, heart failure) that may influence the decision to refer to music therapy.
Said Dr. Rodgers-Melnick, "This study reveals important characteristics about the kinds of patients music therapists see in the hospital. Ultimately, for music therapy to have an impact on patients' length of stay and opioid utilization, our services will likely have to be delivered at a higher dose and in coordination with other organizational-level initiatives."
More information
Samuel N. Rodgers-Melnick et al, Effectiveness of Music Therapy on Utilization Outcomes among Surgical Patients with Mental Health Conditions: A Propensity-Score Matched Cohort Study, Journal of Integrative and Complementary Medicine (2026). DOI: 10.1177/27683605261444109
Key medical concepts
Music TherapyMental Disordersopioid useAnalgesics, OpioidHeart Failure
Clinical categories
Psychology & Mental healthAllied healthPsychiatryGeneral surgery Provided by University Hospitals Cleveland Medical Center Who's behind this story?
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