Associate Professor Natasha Smallwood
Patients with serious respiratory illness appear to be experiencing psychological benefits as well as symptom improvement after just a few sessions of singing music therapy, the TSANZ 2023 Annual Scientific Meeting has heard.
Professor Natasha Smallwood has been recruiting patients with COPD, ILD and breathlessness into weekly group singing classes since last year, as part of the first Australian trial into the modality.
Held online over Zoom every Thursday, the classes each last 90 minutes, with participants encouraged to focus on breathing control while singing songs of their choice from any genre.
While singing therapy is not a new idea, Professor Smallwood said she decided to launch a trial after a landmark Danish study in 2021 found it was non-inferior to pulmonary rehab in its impact on patients’ exercise tolerance.
“That is a massive finding, because we know that many people do not like doing pulmonary rehab even if they have severe disease,” she told the conference in Christchurch on Saturday.
“So this isn’t to say that pulmonary rehab should be replaced, but this is a great alternative and we really should consider the role of singing for breathing in people who have either completed it and don’t want to do it again or are unwilling to do it.”
Called SINFONIA (benefits of SingINg FOr breathing in COPD aNd ILD pAtients), the trial had a recruitment target of 140 patients, who joined from around the country.
And while feedback from trial participants was overwhelmingly positive, Professor Smallwood stressed hitting that target did prove challenging – mostly due to shyness.
“It’s the hardest clinical trial I have ever had to sell to patients, because they are all frightened of singing in a group,” she said.
“It was only when I told them ‘it’s alright, it’s on Zoom, you can mute’ that they tended to agree to give it a go.”
Nevertheless, previous studies showed most would grow in confidence over time and in fact were ‘desperately sad’ when the program ended.
Professor Smallwood also gave an overview of her recent research into palliative care for patients with respiratory illnesses, which she said had suggested a need for respiratory specialists to take a more proactive role.
She referred to research she published in 2018 which suggested only 18% of Australian patients with COPD and 36% of those with ILD accessed specialist palliative care in the last two years of life.
“The really critical thing is we know specialist and generalist palliative care work best when the patient actually accesses it, and does so early,” she said.
“And that means we’re not just talking about prognosis, we’re looking at what the needs of that person and their family are.”
She added: “If we leave this to our palliative care colleagues, they don’t have the capacity to do this as they are already overwhelmed dealing with patients with cancer. That puts the onus back on us.”