The impact of music on health-related quality of life, as quantified by the SF-36: A systematic review and meta-analysis

Background/Objectives Increasing evidence supports the ability of music to broadly promote wellbeing and health-related quality of life (HRQOL). However, the magnitude of music’s effects on HRQOL is still unclear, particularly relative to established interventions, limiting inclusion of music interventions in health policy and care. The SF-36 is the most widely used instrument to evaluate HRQOL, with broad validity in evaluating the effects of a range of interventions. This study aims to synthesize and contextualize the impact of music interventions on HRQOL, as assessed by the SF-36. Methods MEDLINE; EMBASE; Web of Science; PsycINFO, clinicaltrials.gov, and ICTRP databases were searched on 30 July 2021. Randomized and single-group studies of music interventions which reported SF-36 data at pre- and post-intervention timepoints were included. Observational studies were excluded. The quality and certainty of evidence provided by included articles and meta-analysis results was appraised using GRADE. Inverse variance random effects meta-analyses quantified changes in SF-36 mental and physical component summary scores (respectively, ‘MCS’ and ‘PCS’) pre- to post-intervention and vs. common control groups. Results Analyses included 764 participants from 25 studies. Music interventions (music listening – 10 studies; music therapy – 7 studies; singing – 7 studies; gospel music – 1 study) significantly improved MCS (Mean difference (MD) [95% confidence interval]=3.0 [1.4, 4.6]; p<.001) and PCS (MD=1.0 [0.1, 2.0; p<.04) scores. In a subgroup (8 studies; music group – N=254; control – N=257) addition of music to standard treatment for a range of conditions significantly improved MCS scores vs. standard treatment alone (MD=3.7 [0.4, 7.1; p<.03). Effects did not vary between music listening, therapy and singing intervention types or doses ( p≥ . 12 ); no evidence of small study or publication biases was present in any analysis ( p≥ . 31 ). Music’s impact on MCS scores meets SF-36 minimum important difference thresholds (MD≥3) and is within the range of established interventions. Conclusions This study provides Moderate quality evidence that music interventions can generally be used to provide clinically meaningful improvements in HRQOL. Further study is needed to determine optimal music interventions and doses for distinct clinical and public health scenarios. Funding Alexander von Humboldt Foundation Registration PROSPERO (ID: CRD42021276204)