Classical Indian music for managing anxiety and pain among patients in a hospital setting: a systematic review and meta-analysis of randomized controlled trials.

Abstract

Background: The quantitative impact of classical Indian music (CIM) on pain and anxiety is relatively underexplored. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess whether music medicine (MM) using CIM improves anxiety and/or pain among patients of all ages in a hospital setting.

Methods: We searched PubMed, MEDLINE, PsychInfo, Embase, and Google Scholar from their inception until January 29, 2025. The pooled estimate of standardized mean differences (SMD) was calculated using the fixed and random-effects model and reported using Woolf's inverse variance. Data represented in standardized effect size with 95% CI. The risk of bias and the certainty of evidence were analyzed using RevMan v5.4 and GRADE.

Results: Nine RCTs were included in the systematic review and two RCTs (197 participants) in the meta-analysis. CIM was found not to have a significant benefit on anxiety (SMD 0.14 [-0.14 to 0.42]), systolic blood pressure (SMD -0.20 [-0.73 to 0.34]), diastolic blood pressure (SMD -0.03 [-0.39 to 0.34]), and pulse rate (SMD -0.96 [-2.50 to 0.57]). No substantial statistical heterogeneity was observed. The certainty of the evidence was very low.

Conclusions: Our meta-analysis could not ascertain any positive relationship between CIM and anxiety, SBP, DBP, and PR. We recommend greater research efforts through robust RCTs and policies to develop a National Medical Commission-accredited CIM-based music therapy service in India.