A systematic review and meta-analysis on the role of music in reducing anxiety and discomfort during flexible sigmoidoscopy


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Arun P Shanmuganandan1,Muhammed Siddiqui1,Nicholas Farkas1,Rhys Thomas1,Said Mohamed1,Al Mutaz Abulafi1,Robert Swift1
1Croydon University Hospital NHS Trust

Abstract

Background

The use of flexible sigmoidoscopy(FS) is becoming more prevalent especially in the context of bowel cancer screening, however uptake remains low. A meta-analysis was performed of comparative studies investigating the role of music in reducing anxiety and discomfort in patients undergoing screening flexible sigmoidoscopy.

Method

A systematic review of comparative studies up to August 2016, without language restriction were identified from MEDLINE, the Cochrane Controlled Trials Register (1960–2016), and EMBASE (1991–2016).Further searches were performed using the bibliographies of articles and abstracts from major conferences. Medical Subject Headings(MeSH) and text word terms used included “sigmoidoscopy”, “music” and “endoscopy” and “anxiety”.

All studies reporting on the effect of music on anxiety or pain after flexible sigmoidoscopy, in adults, were included. Outcome data was extracted by 2 authors independently using outcome measures defined a priori. Quality assessment was performed using Risk of Bias tables.

Results

Data from 3 studies, with a total of 138 patients, were extracted and analyzed using open metaanalyst. Patients who listened to music during their flexible sigmoidoscopy had less anxiety compared to those who did not [Random effects; SMD: 6.68(3.84,9.52), S.E=1.45, p<0.001]. There was no statistical heterogeneity (Q=6.68, df=1, p=0.719, I2=0). Patients who listened to music during their flexible sigmoidoscopy had less pain compared to those who did not [Random effects; SMD:1.13(0.52,1.75), S.E=0.31,p<0.001]. There was no statistical heterogeneity (Q=0.40,df=1,p=0.528, I2=0). Patients who listened to music during their flexible sigmoidoscopy found it was a helpful intervention compared to those who did not [RR:0.61(0.46,0.80),p<0.001]. There was no statistical heterogeneity (Q=0.999,df=1,p=0.318, I2=0).

Conclusion

Music appears to reduce anxiety, pain and was deemed a helpful intervention when undergoing flexible sigmoidoscopy. Utilization of this adjunct can potentially improve patient experience and uptake of this screening test. There is a paucity of studies focusing solely on flexible sigmoidoscopy and further studies may consolidate our findings.