Research knowledge on links between music and wellbeing can be used to establish how a musical intervention might improve health, in the same way as research is used to develop and implement new drugs, surgical procedures, talking therapies or lifestyle advice. For instance, if listening to music can help patients to cope with chronic pain or anxiety around operations, it could be prescribed to help those in pain or adopted into clinical procedure. But this may raise more questions: what music should be played? How and when? How practical and cost-effective is it to do this in a clinical setting or at home?
Since music is diverse, involves social interaction, and engages many mental and physical processes, music interventions are often complex. For instance music therapy can involve different musical activities of varying length, tailored to the individual patient and delivered in the social context of interaction with a therapist. Medical Research Council guidelines show that developing complex interventions for wider implementation requires a progression of studies with different aims and methods, including:
- Fundamental work to establish whether and how a specific use of music has a specific effect on health
- Design and testing of an intervention based on this knowledge
- Pilot or feasibility studies to explore how this intervention can be implemented and evaluated
- Evaluations and clinical trials of the intervention in experimental or real-world (NHS or community) settings, to establish efficacy or effectiveness.
Qualitative studies, where a relatively small number of people are observed and interviewed in depth, are used to explore how or why music affects people and how they experience music in relation to their wellbeing. This approach allows them to contribute from their own point of view. Quantitative studies measure how much specific biological or psychological characteristics are affected by music, or the extent to which people perceive change themselves following musical involvement. Clinical trials can show whether one intervention makes a difference compared to another or to no intervention, and Clinical Trials Units at universities in Glasgow, Edinburgh, Aberdeen and Dundee can offer support in all aspects of clinical trial research from concept through to analysis and reporting.
Most research carried out in this area involves collaboration between music researchers or practitioners and clinical experts. It is also a priority for the NHS and most research funders that patients or members of the public should be integrally involved the research process, not just as participants but advising on approaches, monitoring acceptability and appropriateness, and helping to communicate findings. This gives a voice to those targeted by interventions and ensure these are appropriate for patients and recognise their needs and preferences. The Chief Scientist’s Office runs a Public Engagement Group to consult on this.
It is also vital that any research on music and health is conducted to a high ethical standard to protect those taking part, and any research recruiting NHS patients must first gain approval from the NHS Scotland Research Ethics Service.