Virtual reality distraction therapy
Topic Status Complete
Virtual reality therapy for the management of procedure-related pain.
Outcome of the appraisal
The evidence partially supports the adoption of virtual reality interventions for the management of pain and anxiety in adults and children undergoing medical procedures, but the evidence is insufficient to support routine adoption.
The use of VR reduces pain and anxiety associated with a range of medical procedures as compared with standard care and is well tolerated.
While there is the potential for cost savings through a reduction in the use of analgesics, sedation or anaesthesia, the evidence to support this is currently limited. HTW would encourage the gathering of further evidence to define the economic and clinical impact of virtual reality in more detail.
Why was this topic appraised?
The management of pain during medical procedures is critical to optimising patient experience. Common medical procedures that require pain management include wound care, dressing changes, physical therapy for burns, dental treatment, chemotherapy, intravenous (IV) access, and childbirth. Pharmacological approaches are often used to minimise procedural pain, but these can have significant drawbacks, including imprecise titration, narrow therapeutic windows, adverse side effects, high costs and potential for drug misuse.
Distraction therapy using virtual reality (VR) interventions may provide an alternative approach for managing procedural pain. VR immerses people within an artificial 3-dimensional (3D) environment through sensory stimuli, that include visual, auditory, and often touch sensations. This immersion, sometimes coupled with the possibility of active exploration of virtual environments, might facilitate a shift of attention away from any pain experienced.
Plain language summary
A medical procedure is a course of action intended to achieve a result in the delivery of healthcare. This can include tests, scans, examinations and treatments. The delivery of some medical procedures can involve the experience of pain. For some, both the anticipation and delivery of medical procedures can also cause anxiety and distress as well as pain. Pain is usually managed by medication. Common medical procedures that require pain management include but are not restricted to wound care, dressing change and physical therapy for burns, dental treatment, chemotherapy, intravenous (IV) access, and labour. While pain medication can be helpful and, when properly administered, perfectly safe, there are some drawbacks. These can include taking the wrong amount of medication, the effects of medication only lasting a short time, adverse side effects, high costs and potential for drug misuse.
A popular alternative to using medication to manage pain is to seek to distract the person in order to take their attention away from the pain they are feeling. Distraction can take many forms, including reading books, watching movies, listening to music and the use of virtual reality.
Virtual reality is a computer generated simulation of an environment. A picture of a chosen environment is displayed through a headset or glasses. The environment can be interacted with, allowing the user to feel as if they are really there. The use of virtual reality has already been applied in areas of healthcare, including to help treat phobias and anxiety disorders,
Health Technology Wales looked for evidence that virtual reality can be used to manage pain associated with medical procedures. The evidence partially supports the adoption of virtual reality interventions for the management of pain and anxiety in adults and children undergoing medical procedures, but the evidence is insufficient to support routine adoption.
This is an updated version of an appraisal originally published in May 2020. The supporting documents from previous appraisals are available from HTW upon request.