Impact of Live Preferential Music on Pain in the Emergency Care Setting: A Randomized Controlled Trial.
8 affiliations
- 1University of Florida Center for Arts in Medicine, Gainesville, Florida.
- 2University of Alabama at Birmingham Heersink School of Medicine, Department of Emergency Medicine, Birmingham, Alabama.
- 3University of Florida, College of Nursing, Department of Biobehavioral Nursing, Gainesville, Florida.
- 4The Ohio State University, College of Medicine, Department of Medicine, Emergency Medicine, Columbus, Ohio.
- 5University of Florida, Department of Neurosurgery, Gainesville, Florida.
- 6IQVIA, Newberry, Florida.
- 7University of Florida Institutional Review Board, Gainesville, Florida.
- 8Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan.
Abstract
Introduction
Pain is the most prevalent complaint for the more than 155 million patients accessing emergency care in the United States. Appropriate and timely management of pain is a measure of quality emergency care. However, the opioid crisis has created a need for multimodal and alternative approaches to successful pain management. Models for integrating such approaches in emergency departments (ED) are understudied. Therefore, we chose to investigate the impact of live preferential music (LPM) in the management of acute musculoskeletal pain.Methods
This prospective, randomized, double-blind intervention study was designed with block randomization clustered by day of the week to live preferred music versus usual care. To ensure blinding, patients were deceived that the study focus was on pain assessment without disclosure that there was an intervention. A total of 2,262 patients were screened, and 272 patients (94 interventions, 128 usual care controls, and 50 declined-music intervention) were recruited from two free-standing EDs. All subjects received analgesics per prescription, had vital signs measured, and completed baseline and follow-up Pain Intensity Number Scale (0-10) scores via PAINReportIt. We calculated morphine equivalents for pain medications in the ED.Results
The mean age of the 222 patients in the per-protocol analytic sample was 48.3 years (95% confidence interval, 45.9-50.7); 64% were female, 29% Black; and their triage acuity was 4% emergent Emergency Severity Index (ESI) 2, 52% urgent ESI 3, and 44% less urgent ESI 4. There were absolute reductions in current pain intensity from baseline in both the control (-1.21) and intervention (-1.34) groups (difference -0.14, 95% CI, -0.48 to 0.76). However, the difference was not significant in posttest pain intensity when controlling for baseline pain intensity (P = .29). Qualitative analysis reflected patient-reported reduction in the perception of pain as a common theme. Vital signs and morphine equivalents were similar between groups.Conclusion
This study demonstrated that live preferential music interventions are feasible to study rigorously in the ED. Patients were enrolled using deception and were not informed of the study's focus on music or their potential exposure to music. However, they were told initially that they would be part of a pain assessment study. Although significant between-group differences were not observed, the general theme of patient-reported reduction in the perception of pain suggests that a more highly powered study might detect significant effects in pain reduction with LPM. Variation in clinician care strategies and evolving federal guidelines for pain management may have influenced study processes and outcomes.
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BibTeX
@article{sonke2026impact,
title = {{Impact of Live Preferential Music on Pain in the Emergency Care Setting: A Randomized Controlled Trial.}},
author = {Jill Sonke and Marie-Carmelle Elie and Diana J Wilkie and Henry W Young and Muhammad Abdul 'Baker' Chowdhury and Meenakshi Puthucode Balakrishnan and Cindy Montero and Joseph Adrian Tyndall},
journal = {The western journal of emergency medicine},
year = {2026},
month = sep,
doi = {10.5811/westjem.61331},
url = {https://europepmc.org/article/MED/42900949},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of Live Preferential Music on Pain in the Emergency Care Setting: A Randomized Controlled Trial.
AU - Jill Sonke
AU - Marie-Carmelle Elie
AU - Diana J Wilkie
AU - Henry W Young
AU - Muhammad Abdul 'Baker' Chowdhury
AU - Meenakshi Puthucode Balakrishnan
AU - Cindy Montero
AU - Joseph Adrian Tyndall
PY - 2026
DA - 2026/09/09
JO - The western journal of emergency medicine
DO - 10.5811/westjem.61331
UR - https://europepmc.org/article/MED/42900949
AB - Introduction Pain is the most prevalent complaint for the more than 155 million patients accessing emergency care in the United States. Appropriate and timely management of pain is a measure of quality emergency care. However, the opioid crisis has created a need for multimodal and alternative approaches to successful pain management. Models for integrating such approaches in emergency departments (ED) are understudied. Therefore, we chose to investigate the impact of live preferential music (LPM) in the management of acute musculoskeletal pain.Methods This prospective, randomized, double-blind intervention study was designed with block randomization clustered by day of the week to live preferred music versus usual care. To ensure blinding, patients were deceived that the study focus was on pain assessment without disclosure that there was an intervention. A total of 2,262 patients were screened, and 272 patients (94 interventions, 128 usual care controls, and 50 declined-music intervention) were recruited from two free-standing EDs. All subjects received analgesics per prescription, had vital signs measured, and completed baseline and follow-up Pain Intensity Number Scale (0-10) scores via PAINReportIt. We calculated morphine equivalents for pain medications in the ED.Results The mean age of the 222 patients in the per-protocol analytic sample was 48.3 years (95% confidence interval, 45.9-50.7); 64% were female, 29% Black; and their triage acuity was 4% emergent Emergency Severity Index (ESI) 2, 52% urgent ESI 3, and 44% less urgent ESI 4. There were absolute reductions in current pain intensity from baseline in both the control (-1.21) and intervention (-1.34) groups (difference -0.14, 95% CI, -0.48 to 0.76). However, the difference was not significant in posttest pain intensity when controlling for baseline pain intensity (P = .29). Qualitative analysis reflected patient-reported reduction in the perception of pain as a common theme. Vital signs and morphine equivalents were similar between groups.Conclusion This study demonstrated that live preferential music interventions are feasible to study rigorously in the ED. Patients were enrolled using deception and were not informed of the study's focus on music or their potential exposure to music. However, they were told initially that they would be part of a pain assessment study. Although significant between-group differences were not observed, the general theme of patient-reported reduction in the perception of pain suggests that a more highly powered study might detect significant effects in pain reduction with LPM. Variation in clinician care strategies and evolving federal guidelines for pain management may have influenced study processes and outcomes.
SN - 1936-900X
SN - 1936-9018
ER -