- Design
- Cochrane systematic review and meta-analysis of 27 randomised trials
- Population
- 1,584 adults on maintenance haemodialysis, 13 countries
- Primary outcome
- Fatigue, blood pressure, depression and pain
- Effect
- Short-term depression SMD −0.88 (−1.51 to −0.25); pain SMD −0.89 (−1.63 to −0.15); low certainty
This Cochrane review included 27 randomised trials with 1,584 people on maintenance haemodialysis in 13 countries, comparing music-based interventions with usual care, headphones without music, white noise or video.
Music may reduce short-term fatigue (one trial, 62 people; mean difference −3.1 on a 10-point scale), short-term pain (SMD −0.89, 8 trials) and depressive symptoms in the short term (SMD −0.88, 6 trials) and medium term (SMD −0.81, 5 trials), all low-certainty evidence. Effects on blood pressure were very uncertain. No trial measured outcomes beyond six months, and heterogeneity was often high.
Music is cheap, safe and acceptable to many patients, and dialysis sessions offer hours of otherwise idle time. The evidence is not strong enough to promise benefit, but it is reasonable to offer as part of symptom care.
- Offer patients the option of music with headphones during dialysis sessions.
- Screen regularly for fatigue, pain and depression, which are common and under-treated on dialysis.
- Do not substitute music for treatment of clinical depression.
- Ask patients what they find helpful; preference likely matters.
Why it matters
Symptom burden on dialysis is large, and simple measures that patients value deserve a place.
Don't overread it
Certainty is low to very low, with small trials and high heterogeneity; long-term effects are unknown.
The statistics, in plain English
A standardised mean difference around −0.9 is a moderate-to-large effect, but with I² up to 92% the trials disagreed widely, so the true benefit may be much smaller.
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