Music therapy and gardening enhances post-discharge adherence in psychiatric patients
W. Jung1,2, I. Jang3,4, H. Lim5, S. Jeong6, H.J. Lee2, G. Han7, S.-Y. Park2, H. Jeong2, Y. Kim2, S. Lee2, E. Lee8, K.-Y. Choi1
1College of Medicine, Chungnam National University, Department of Psychiatry, Daejeon, Korea, Republic of, 2Chungnam National University Hospital, Department of Psychiatry, Daejeon, Korea, Republic of, 3Chungnam National University, Department of Statistics and Data Science, Daejeon, Korea, Republic of, 4Orea Research Institute of Bioscience and Biotechnology, Korea Bioinformatics Center, Daejeon, Korea, Republic of, 5Chungnam National University, Institute of Natural Sciences, Daejeon, Korea, Republic of, 6Seoul National University Hospital, Biomedical Research Institute, Seoul, Korea, Republic of, 7Chungnam National University, Department of Mathematics, Daejeon, Korea, Republic of, 8Chungnam National University, Department of Information and Statistics, Daejeon, Korea, Republic of
Background: Maintenance pharmacotherapy after acute hospitalization for schizophrenia, bipolar disorder, and major depression is vital for relapse prevention and functional recovery. However, medication adherence, measured by proportion of days covered (PDC) and medication possession ratio (MPR), averages 50% (range: 20-80%). Interventions like medication education and motivational interviewing improve adherence but lack sustained impact without ongoing support. Horticultural and music therapies reduce depression and anxiety.
Aims & Objectives: This study evaluates their impact on medication adherence and outpatient treatment retention 6-12 months post-discharge.
Method: From July 2022 to July 2023, 139 patients at Chungnam National University Hospital’s psychiatric ward received weekly horticultural therapy and music therapy (treatment group). A control group of 278 patients, hospitalized from July 2020 to June 2022, was matched 1:2 by gender, age, and diagnosis (schizophrenia, bipolar disorder, depression, others). Of 445 patients, 387 were analyzed after excluding those without post-discharge visits. Age groups were young (<30), middle (30-60), and older (>60). Adherence, assessed by MPR and PDC over 12 months, was analyzed using repeated-measures ANOVA; retention was evaluated with a Cox proportional hazards model.
Results: The treatment group showed significantly higher MPR at 4, 6, and 8 months post-discharge, but not at 10 or 12 months. Age and music therapy participation were significant factors in ANOVA and Cox models. Young-, middle-aged patients and music therapy participants had higher adherence and retention.
Discussion & Conclusions: Music therapy during hospitalization improved medication adherence up to 8 months post-discharge and enhanced outpatient retention, particularly in young and middle-aged patients.
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