Music Therapy in Medical Care

Sam Rodgers-Melnick, MPH, MT-BC, an Integrative Health Research & Data Specialist with University Hospitals (UH) Connor Whole Health and a doctoral student in the Clinical Translational Science Program at Case Western Reserve University (CWRU) School of Medicine was awarded a two-year F31 Predoctoral Fellowship Award from the National Center for Complementary and Integrative Health (NCCIH), a Division of the National Institutes of Health (NIH). The F31 proposal, entitled Developing Real-world Understanding of Medical Music therapy using the Electronic Health Record (DRUMMER), leverages electronic health record (EHR) data to investigate the real-world clinical effectiveness of music therapy for addressing patients’ needs throughout ten medical centers in the UH Health System.

Sam began his career as a music therapist at UH Seidman Cancer Center in 2013 following the completion of his undergraduate degree in music therapy at Duquesne University in Pittsburgh, PA. After developing several music therapy interventions for addressing the needs of adults with sickle cell disease, he received two consecutive grants from the Kulas Foundation to lead the first-ever systematic research on the impact of music therapy among individuals with sickle cell disease. Over the next five years, Sam collaborated with an interdisciplinary team of researchers and healthcare professionals on a series of studies to understand how adults with sickle cell disease use music to address their needs and the impact of music therapy on acute pain, health-related quality of life and the transition from pediatric to adult care.

Sam’s research has since grown to include qualitative research related to tobacco cessation in oncology; survey studies investigating perceptions of integrative modalities among patients with cancer, caregivers and healthcare providers; and a retrospective study examining the impact of massage therapy among children, adolescents and young adults with hematologic and oncologic conditions.

Sam’s most recent work has focused on investigating the real-world clinical effectiveness of medical music therapy using EHR data. He recently authored four publications demonstrating (1) how music therapy can be integrated throughout a large health system; (2) 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 (3) a quality improvement initiative to increase patient-reported outcome collection among a medical music therapy team.

DRUMMER builds upon this most recent work using a novel dataset of over 30,000 music therapy sessions provided to over 15,000 patients. A drummer himself, Sam will pursue the following three aims over the course of his F31 Fellowship: (1) investigate which patient and/or music therapy session characteristics are associated with changes in patient-reported outcome measures (i.e., stress, pain, anxiety, and coping); (2) compare utilization outcomes (i.e., length of stay and medications administered for pain and anxiety) and longitudinal pain intensity scores between inpatients receiving music therapy and propensity score matched controls; and (3) examine the longitudinal effects on patient-reported outcome measures among patients receiving music therapy over the course of their hospital admissions.

Supporting Sam during his fellowship are a group of mentors from CWRU including (1) Johnie Rose, MD, PhD, Associate Professor in the School of Medicine’s Center for Community Health Integration; (2) Jeffery A. Dusek, PhD, Associate Professor in the Department of Family Medicine and Community Health; (3) Siran M. Koroukian, PhD, Professor in the Department of Population and Quantitative Health Sciences; (4) Douglas Gunzler, PhD, Associate Professor in the Department of Population and Quantitative Health Sciences; (5) Thomas E. Love, PhD, Professor in the Department of Population and Quantitative Health Sciences; and (6) Mark Beno MSM, Executive Director of the Cleveland Institute for Computational Biology.

“This study has so much clinical and public health relevance because it will help us better understand how non-pharmacologic interventions may be better leveraged to manage pain and anxiety—and it does so with an unprecedentedly large and robust data set, whose creation Sam has orchestrated.” said Johnie Rose, MD, PhD, who serves as a Sponsor for Sam’s F31. In addition to leveraging statistical methods including regression models, propensity score matching, and longitudinal mixed effects models, Sam’s proposal will also make use of Electronic Medical Record Search Engine (EMERSE), a platform that allows for the rapid search of over 46 million clinical notes within the UH EHR.

“Real-world effectiveness research is a crucial step in aiding our understanding of how the arts impact health. As a systemwide program, the UH Connor Whole Health music therapists provide a tremendous service by implementing frontline care that supports both physiological and psychological vulnerabilities faced by critically-ill patients. This level of research is able to take place thanks to the combined efforts of these clinical providers,” said Seneca Block, MA, MT-BC, The Lauren Rich Fine Endowed Director of Expressive Therapies at UH Connor Whole Health. UH Connor Whole Health manages the largest health system-based music therapy program in the US with 11 board-certified music therapists who collaborate with providers across the system to help patients and their families manage the physical and emotional toll of an illness or hospitalization. “The NIH has recognized that Sam Rodgers-Melnick is a trailblazer. His work is real and impactful,” added Francoise Adan, MD, Chief Whole Health and Well-Being Officer for UH and Director of UH Connor Whole Health.

Through this fellowship, Sam will gain skills and experience needed to conduct future practice-based clinical effectiveness research not only in music therapy, but across multiple integrative therapies (e.g., acupuncture and massage) deployed within health systems. The results derived from this work will strengthen the evidence base for integrative therapies and guide implementation of nonpharmacologic pain management modalities. As health systems develop EHR-based quality improvement tools and implement nonpharmacologic pain modalities, the findings from this research will be especially important for understanding the real-world impact of integrative health and medicine modalities and improving evidence-based patient care.

Research reported in this publication was supported by the National Center For Complementary & Integrative Health of the National Institutes of Health under Award Number F31AT012592. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.