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Network Meta-analysis of the Efficacy of Different Music Therapy Interventions for Delirium in Adult Intensive Care
Yunfan Hao1, Ruihan Song2, Aixin Wang1
1Department of Nursing, Jinan Beicheng Hospital, Jinan, Shandong Province, China.
Background And Aims:
Delirium is common in adult intensive care unit (ICU) patients and is associated with worse outcomes. Music-based interventions are increasingly used, but the relative effectiveness of different programs remains unclear. We conducted a network meta-analysis (NMA) to compare multiple music therapy interventions for ICU delirium.
Data Sources:
We searched major Chinese and English databases (e.g., CNKI, PubMed, and the Cochrane Library) from inception to 21 August 2025.
Study Selection:
Randomized controlled trials comparing music-based interventions with usual care (UC) in adults (≥18 years) in the ICU were eligible. Interventions were categorized as simple music (SM) therapy, traditional Chinese medicine (TCM) five-element music, family voice stimulation combined with music (FS), and combined music (CM) therapy (music combined with another nonpharmacological component).
Data Synthesis:
A frequentist random-effects NMA (R, netmeta) was performed. Compared with UC, all music-based interventions were associated with a reduced delirium incidence [CM: Risk ratio (RR) = 0.43; TCM: RR = 0.45; FS: RR = 0.48; SM: RR = 0.51]. For delirium duration, CM [mean difference (MD) = -3.21 days] and TCM (MD = -2.89 days) showed statistically significant reductions, whereas SM and FS did not. The network ranking suggested CM had the highest probability of benefit; however, between-intervention differences were mainly supported by indirect comparisons and small trials. Heterogeneity and potential small-study effects were observed.
Conclusion:
Music-based interventions may reduce ICU delirium incidence, and some programs may shorten delirium duration. Because evidence is limited by heterogeneity, possible publication bias, and a paucity of head-to-head trials, rankings should be interpreted cautiously. Well-designed, multicenter RCTs with standardized protocols are needed before firm recommendations can be made.
How To Cite This Article:
Hao Y, Song R, Wang A. Network Meta-analysis of the Efficacy of Different Music Therapy Interventions for Delirium in Adult Intensive Care Unit Patients. Indian J Crit Care Med 2026;30(4):335-343.