Music to Their Ears: Reducing Antipsychotic Use With a Personalized Music Intervention for Rural Veterans

Background This project investigates a music intervention to deprescribe antipsychotics in rural Veterans with dementia. Methods The Veterans Health Administration Home-Based Primary Care Program is care provided in the home by an interdisciplinary team with the goals of decreasing hospitalizations and falls, providing education to patients and caregivers, and improving quality of life. Eighteen Home Based Primary Care Veterans with dementia and active antipsychotic prescriptions were identified with the goal to deprescribe antipsychotics in 50% of them using a music intervention. Individualized playlists and assessments for Veteran quality of life and caregiver burden were evaluated. Phone visits tracked music utilization and captured the voice of the customer. Results Antipsychotic dose reduction occurred in five of eight Veterans, totaling eight dose reductions and one discontinuation. Veteran quality of life improved; however, caregiver burden increased initially. The caregiver burden did improve when an outlier was removed. The voice of the customer favored music intervention. Conclusions A personalized music intervention is a feasible approach for reducing antipsychotic use in rural Veterans, improving quality of life, and potentially reducing caregiver burden.