The Effects of Arts-Based Interventions in the Treatment and Management of Non-Communicable Diseases: An Umbrella Review and Meta-Analyses

Background A considerable number of published reviews have addressed the treatment effects of arts-based interventions for health outcomes in people with noncommunicable diseases (NCDs). It is important to summarise this evidence base to inform policy and practice, identify research gaps, and provide research recommendations. Methods We searched The Cochrane Database of Systematic Reviews, Web of Science, CINAHL, Medline, PsycINFO, and Embase for systematic reviews published between database inception and 7 September 2023. We included systematic reviews (SR) with meta-analyses that summarised the effects of arts-based interventions on psychological, physical, cognitive functioning, or quality of life outcomes in people with cancer, cardiovascular disease (CVD), chronic respiratory disease (CRD), diabetes, mental health conditions, or neurological conditions. Eligible effect sizes (ES) were converted to standardized mean difference (SMD) with 95% confidence intervals (CI). Overall ES were calculated for each NCD population as well as across the four outcome domains, supplemented with subgroup analysis on study-, outcome-, and intervention variables. For all meta-analyses, we used restricted likelihood multilevel meta-analysis to account for non-independence of ES within individual meta-analyses. We assessed methodological quality using the Measurement Tool to Assess Systematic Reviews-2 checklist. This umbrella review was registered with PROSPERO (CRD42023493088). Findings Our search resulted in 3,885 unique citations, of which 150 SR (including 576 ES) were included in our analyses. Music and dance interventions contributed 86.6% of ES estimates. We found a small-to-medium overall effect for neurological conditions (SMD 0.40, 95% CI 0.30–0.50) and medium effects for cancer (SMD 0.52, 95% CI 0.38–0.66), CVD (SMD 0.52, 95% CI 0.35–0.71), mental health conditions (SMD 0.53, 95% CI 0.39–0.68), and CRD (SMD 0.76, 95% CI 0.38–1.13). Most reviews were of low methodological quality. Interpretation Our findings indicate that people with NCDs may benefit from arts-based interventions for physical, psychological, cognitive functioning and QoL outcomes. Therefore, arts-based interventions may be a valuable addition to traditionally first-line treatments such as psychotherapies, pharmacotherapies, and standard medical treatment for NCDs. *Martina de Witte and Joke Bradt are co-primary authors. **Felicity Baker and Amit Lampit are co-supervising authors.