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A. Astek1, L. Sheeran1, V. Sparkes1
1Cardiff University, Cardiff, United Kingdom
Background: Immersive virtual reality (IVR) refers to technology where users wear head-mounted display (HMD) supported by software, enables interaction with a 3D virtual environment (VE). The use of this technology as a non-pharmacological form of analgesia has been supported for acute procedural pain. Alongside, the development of IVR technology as an intervention for chronic pain (CP) is substantially growing, but its efficiency is still unknown. The lack of consensus on working mechanisms, technology specifications(hardware/software) and considerations for CP population makes it difficult to implement such technology in clinical practice. Therefore, pre-investigation about the intervention could inform future IVR development and implementation as well as optimise the benefits in the context of CP.
Purpose: This study aimed to explore the experiences and perceptions of healthcare practitioners and IVR technology developers with experience of developing and using IVR in people with CP. This includes
1) experiences of delivering IVR as an intervention for CP including benefits and adverse events,
2) opinions on key considerations around technology (software/hardware), the dose of the intervention and the clinical context of IVR,
3) perceived facilitators and barriers for future implementation of IVR for CP.
1) experiences of delivering IVR as an intervention for CP including benefits and adverse events,
2) opinions on key considerations around technology (software/hardware), the dose of the intervention and the clinical context of IVR,
3) perceived facilitators and barriers for future implementation of IVR for CP.
Methods: The study was part of a multi-phase mixed methods design. This study involved semi-structured 1-hour interviews conducted online using Zoom platform. Ten participants were recruited worldwide consisting of 6 healthcare practitioners, 2 technology developers and 2 IVR company founders. The interviews were transcribed, and scripts were sent to a subset of the participants for data verifications. All data were analysed using thematic analysis.
Results: Perceived benefits of IVR for CP included combating fear of movement and engaging patients in physical exercises and enhancing coping with pain. Screening for patient technology preference, contraindications (e.g., epilepsy, motion sickness) and considering precautions around mental health issues were believed to be crucial to ensure safety. Personalising IVR was perceived as important considering patient needs, functional abilities, and preferences as well as the use of HMD to gradually build the dose upon the patient tolerance. Practically, lightweight wireless HMD and hygiene were perceived to be essential. The potential risks of motion sickness, eye strain, and anxiety were thought to be highly individual and thought to be reduced through screening but not eliminated. Starting the delivery of IVR intervention under clinical supervision was considered essential for safety purposes. Also, virtual access of practitioners to IVR software was recommended to guide patients and monitor progression throughout the intervention. Technical knowledge and training of practitioners were seen as a facilitator, while cost and lack of technology acceptance were barriers to future implementation.
Conclusions: IVR intervention was perceived to be valuable for patients with CP, but initial screening would be necessary to assess their suitability and reduce any potential risks of side effects. Technology advancement should address personalisation and the suitability of HMD for clinical population.
Implications: Safety should be a priority for future IVR development. Future adoption of IVR is likely to depend on the acceptance, knowledge, and training of practitioners as well as the cost-effectiveness of the intervention.
Funding acknowledgements: This work is funded by a scholarship from King Abdulaziz University, Government of Saudia Arabia.
Keywords:
Immersive virtual reality
Chronic pain
Complex intervention development
Immersive virtual reality
Chronic pain
Complex intervention development
Topics:
Pain & pain management
Innovative technology: information management, big data and artificial intelligence
Pain & pain management
Innovative technology: information management, big data and artificial intelligence
Did this work require ethics approval? Yes
Institution: Cardiff University
Committee: The School of Healthcare Sciences Research Ethics Committee
Ethics number: REC658
All authors, affiliations and abstracts have been published as submitted.
