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Cancer: Can concomitant music therapy contribute to better treatment results? IQWiG Reports - Commission No HT17-02äCancer: Can concomitant music therapy contribute to better treatment results? IQWiG Reports - Commission No. HT17-02-/-Institute for Quality and Efficiency in Health Care: Extracts 2020[May]; ä (ä): äRESEARCH QUESTION OF THE HTA REPORT: The aims of this investigation are to - assess the benefit of music therapy (MT) as a therapy accompanying oncological standard therapy by comparing it to no accompanying therapy or other accompanying therapies in adult cancer patients with regard to patient-relevant outcomes, - determine the costs arising from accompanying MT in comparison with a different or no accompanying therapy in adult cancer patients (intervention costs), - assess the cost effectiveness of MT accompanying standard therapy in comparison with no accompanying therapy or other accompanying therapies in adult cancer patients as well as - review ethical, social, legal, and organizational aspects associated with the intervention. CONCLUSION OF THE HTA REPORT: MT as an accompanying therapy in oncology has already been established in the German healthcare system, particularly in the (acute and palliative) inpatient and rehabilitation settings, through service reimbursement as well as its mentions in national guidelines. The present HTA reveals indications and hints of a short-term benefit of MT in comparison with standard care with regard to fatigue, mood swings, anxiety, anxiety & depression, stress/tension, and health-related quality of life as well as, over the course of several sessions, with regard to cancer-related adverse events, fatigue, and mood swings. In comparison with other accompanying therapies (music medicine, mindfulness-based stress reduction), a hint of greater short-term benefit of MT was found with regard to fatigue and subjective well-being. Notably, the available evidence shows a positive effect particularly for comparatively short-term psychological outcomes and, in general, primarily for non-biological outcomes - soon after the intervention. For most biological (clinical) outcomes as well as for persistent psychological conditions such as depression, there is generally a lack of evidence in favour of MT. However, these short-term effects are to be considered in light of the typically precarious, in some cases life-threatening, situation of patients. Furthermore, MT is a non-invasive intervention associated with few ethical concerns and is impossible to conduct without considerable patient motivation and cooperation. The results on the benefit of MT are transferable to Germany if a consistent professional concept and standardized training and/or certification can be assumed to be in place, which is, however, not entirely the case in view of the current lack of regulation. However, a uniform consensus has been reached on the occupational profile as well as (voluntary) certification. Due to differences in reimbursement and local availability, access to MT (in general and in oncology) is not uniformly regulated among inpatient care, the rehabilitation sector, and outpatient care. Due to a lack of data, some questions cannot be answered at this time: No studies were found on the outcomes of coping or activities of daily living, and no study investigating MT as a group intervention was found. Data are insufficient for performing a comparative analysis of the benefit of MT in different cancer entities or for a comparison of curative versus palliative therapy. In the direct comparison with alternative accompanying therapies, MT in the form defined herein was studied in only 3 out of 10 studies, and no studies investigated it in comparison with "sham treatment". No data are available on cost-effectiveness, and estimating the intervention costs is hindered by a lack of data on average treatment duration and frequency of sessions. Only 1 out of the 10 studies was conducted in an outpatient setting. Two ongoing studies on MT from Israel and Germany were found, and their design might potentially produce insights regarding longer-term effects and coping (outcome of "resilience").ä |
