Implementation of Music in the Perioperative Standard Care of Colorectal Surgery: A Cost-Effectiveness Analysis

Introduction: Randomized controlled trials and meta-analyses have provided evidence of the positive effects of perioperative music interventions on pain, anxiety, and stress. However, the cost-effectiveness is unknown. The objective of this study was to analyze the cost-effectiveness of the implementation of a music intervention in the perioperative care of patients undergoing colorectal surgery.

Methods: A post hoc analysis was performed on patients included in the Implementation of Music Intervention in the PeRiOperatiVe standard care study: a clinical implementation study comparing the effects of perioperative music interventions (post-implementation group, N = 50) to standard care in colorectal surgery (pre-implementation group, N = 50). Main outcomes analyzed were postoperative pain scores and healthcare costs. Propensity score matching with inverse probability weighting was applied. Incremental costs and cumulative pain score differences were estimated using bootstrap analysis with 1000 replications.

Results: Median age of the entire patient population was 62.5. Mean sum of postoperative pain scores on postoperative days 0 to 3 was 9.8 (range 0-40) (95% confidence interval [CI] 8.3-11.4) and 9.9 (95% CI; 7.0-12.9) in the pre- and post-implementation group, respectively (P = 0.970). The total costs were not significantly different between the pre- and post-implementation group in the entire group (€7000 versus €8,070, mean difference of €1070 (bootstrap 95% CI - €1190 - €3336), P = 0.353). Incremental costs were €1288 and €5030 (intention-to-treat and per protocol analysis, respectively) per clinically relevant decrease in pain during postoperative day 0-3.

Conclusions: The implementation of music intervention does not lead to a significant difference in costs. These results can aid clinicians considering the implementation of perioperative music.