Departamento de Farmacología y Pediatría, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Málaga, Spain.
Consejería de Educación, Junta de Andalucía, Delegación Territorial de Málaga, Málaga, Spain.
PLoS One. 2020 Oct 30;15(10):e0241334. doi: 10.1371/journal.pone.0241334. eCollection 2020.
Airway clearance therapy (ACT) is considered an important approach to improve airway clearance in children with cystic fibrosis (CF). Daily ACT administration requires substantial commitments of time and energy that complicate ACT and reduce its benefits. It is crucial to establish ACT as a positive routine. Music therapy (MT) is an aspect of integrative strategies to ameliorate the psycho-emotional consequences of chronic diseases, and a MT intervention could help children with CF between the ages of 2 and 17 develop a positive response. The aim of this randomized controlled trial was to evaluate the effects of specifically composed and recorded instrumental music as an adjunct to ACT. We compared the use of specifically composed music (Treated Group, TG), music that the patient liked (Placebo Group, PG), and no music (Control Group, CG) during the usual ACT routine in children with CF aged from 2 to 17. The primary outcomes, i.e., enjoyment and perception of time, were evaluated via validated questionnaires. The secondary outcome, i.e., efficiency, was evaluated in terms of avoided healthcare resources. Enjoyment increased after the use of the specifically composed music (children +0.9 units/parents +1.7 units; p<0.05) compared to enjoyment with no music (0 units) and familiar music (+0.5 units). Perception of time was 11.1 min (±3.9) less than the actual time in the TG (p<0.05), 3.9 min (±4.2) more than the actual time in the PG and unchanged in the CG. The potential cost saving related to respiratory exacerbations was €6,704.87, while the cost increased to €33,524.35 in the CG and to €13,409.74 in the PG. In conclusion, the specifically composed, played and compiled instrumental recorded music is an effective adjunct to ACT to establish a positive response and is an efficient option in terms of avoided costs. Trial registered as ISRCTN11161411. ISRCTN registry (www.isrctn.com).
气道廓清治疗(ACT)被认为是改善囊性纤维化(CF)儿童气道廓清的重要方法。每日 ACT 管理需要大量的时间和精力,这使得 ACT 变得复杂,并降低了其益处。将 ACT 确立为一种积极的常规是至关重要的。音乐治疗(MT)是整合策略的一个方面,可改善慢性疾病的心理-情绪后果,MT 干预可以帮助 2 至 17 岁的 CF 儿童产生积极的反应。本随机对照试验的目的是评估专门创作和录制的器乐音乐作为 ACT 辅助治疗的效果。我们比较了在 CF 儿童的常规 ACT 治疗中使用专门创作的音乐(治疗组,TG)、患者喜欢的音乐(安慰剂组,PG)和无音乐(对照组,CG)的效果。主要结局,即享受和时间感知,通过验证问卷进行评估。次要结局,即效率,根据避免的医疗资源进行评估。与无音乐(0 分)和熟悉的音乐(+0.5 分)相比,使用专门创作的音乐后,享受程度增加(儿童+0.9 分/父母+1.7 分;p<0.05)。与实际时间相比,时间感知减少了 11.1 分钟(±3.9)(p<0.05),在 PG 中增加了 3.9 分钟(±4.2),在 CG 中不变。与 CG 相比,与呼吸恶化相关的潜在节省成本为 6704.87 欧元,而 CG 增加到 33524.35 欧元,PG 增加到 13409.74 欧元。总之,专门创作、演奏和编译的器乐录音音乐是 ACT 的有效辅助手段,可以建立积极的反应,并且在节省成本方面是一种有效的选择。试验在 ISRCTN 注册(www.isrctn.com),注册号为 ISRCTN80112003。