- Design
- Cochrane systematic review and meta-analysis of 27 RCTs
- Population
- 1584 adults with kidney failure on maintenance haemodialysis
- Primary outcome
- Fatigue, blood pressure, depression and pain
- Effect
- Depression SMD −0.88 (−1.51 to −0.25); pain SMD −0.89 (−1.63 to −0.15); low certainty
This Cochrane review, published in October 2026, included 27 randomised trials with 1584 adults on maintenance haemodialysis in 13 countries. Music-based interventions were compared with usual care, headphones without music, or video.
Music may reduce depressive symptoms in the short term (standardised mean difference −0.88, 95% CI −1.51 to −0.25) and the medium term (−0.81), and short-term pain (−0.89). One trial suggested less short-term fatigue. The effect on blood pressure was very uncertain. Evidence was low or very low certainty, heterogeneity was often high, and no trial reported outcomes beyond six months.
This is not strong evidence, but the intervention is cheap, safe and available on any phone, and dialysis sessions are long. Offering it costs a unit almost nothing. It should sit alongside, not replace, screening and treatment for depression and pain.
- Consider offering music, with headphones, during haemodialysis sessions.
- Let patients choose their own music.
- Continue to screen for and treat depression and pain on their own merits.
- Do not expect an effect on blood pressure.
Why it matters
Four hours, three times a week, is a lot of time to spend feeling low and in pain.
Don't overread it
Low-certainty evidence from small, short trials; long-term benefit is unknown.
The statistics, in plain English
A standardised mean difference around −0.9 is a moderate-to-large effect on paper, but high heterogeneity (I² up to 92%) means trials disagreed widely, and low certainty means the true effect may be much smaller. Most trials were short and small.
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