Feature

Virtual reality helps reduce pain among patients with sickle cell disease

Anne Marsh, MD
Anne Marsh

Immersive virtual reality appeared effective as a complementary therapy to manage vasoocclusive pain among patients with sickle cell disease.

“In addition to standard therapies, virtual reality may help reduce the pain experience with sickle cell disease vasoocclusive pain episodes,” Anne Marsh, MD, director of the Pediatric Sickle Cell Clinic and associate hematologist/oncologist at UCSF Benioff Children’s Hospital Oakland, and colleagues wrote. “Further study is required to determine the impact of virtual reality therapy on opioid usage and length of stay in hospital.”

Marsh and colleagues sought to determine whether immersive virtual reality could be a feasible treatment approach for a cohort of 30 patients (median age, 16 years; 21 female) with sickle cell disease hospitalized for vasoocclusive pain episodes.

Results showed pain intensity dropped significantly after a single virtual reality session. Investigators observed improvement in sensory, affective, evaluative and temporal pain domains (P .01 for all).

There were no reported side effects, and all patients requested virtual reality therapy in the future, according to the researchers.

HemOnc Today spoke with Marsh about the study and the potential implications of the results.

Question: How did the idea for this research come about?

Answer: Simon Robertson, a volunteer at UCSF Benioff Children’s Hospital Oakland and founder of KindVR, approached the hematology/oncology department and inquired whether we could envision ways to utilize virtual reality to help our patients. Patients with sickle cell disease experience excruciating episodes of pain and often require hospitalization for IV opioids to help relieve pain and suffering. Opioids, although necessary, often are not sufficient. Recognizing the need for novel and accessible nonpharmacologic approaches to pain management, virtual reality seemed like a natural fit for our patients with sickle cell disease.

Q: How did you conduct the study?

A: We enrolled a convenience sample of 30 patients aged 8 years or older with sickle cell disease, all of whom were admitted with a vaso-occlusive pain episode. They participated in a session in which they were immersed in a calming virtual underwater world where they got to explore a marine environment. Patients completed a validated adolescent pediatric pain tool that described the severity, location and character of their pain, both before and after a 15-minute virtual reality session. Patients also completed a survey that assessed safety and acceptability of the session.

Q: What did you find?

A: Virtual reality was well-tolerated and enthusiastically welcomed by the patients. Moreover, virtual reality decreased pain. The median pain score decreased from 7.3 prior to the virtual reality session to 5.8 afterward. The number of body areas where patients experienced pain dropped from three to two.

Q: How might this change practice?

A: We now have virtual reality headsets available in the hospital for routine clinical use. Virtual reality technology has the potential to be used much more widely in both the inpatient, outpatient and emergency room environments to help alleviate pain and anxiety.

Q: Do you have plans for additional research?

A: A clinical trial is underway at UCSF Benioff Children’s Hospital Oakland to evaluate whether virtual reality can help decrease pain and anxiety among pediatric oncology patients who have their mediport accessed in clinic. Additionally, we are studying virtual reality-simulated MRI sessions. If we can show — using a virtual reality-simulated MRI session — that a child is able to lie still for an MRI, we may be able to spare them exposure to anesthesia. – by Jennifer Southall

Reference:

Agrawal AK, et al. Pediatr Blood Cancer. 2019;doi:10.1002/pbc.27525.

For more information:

Anne Marsh, MD, can be reached at UCSF Benioff Children’s Hospital Oakland, 747 52nd St., Oakland, CA 94609; email: amarsh@mail.cho.org.

Disclosure: Marsh reports no relevant financial disclosures.

Anne Marsh, MD
Anne Marsh

Immersive virtual reality appeared effective as a complementary therapy to manage vasoocclusive pain among patients with sickle cell disease.

“In addition to standard therapies, virtual reality may help reduce the pain experience with sickle cell disease vasoocclusive pain episodes,” Anne Marsh, MD, director of the Pediatric Sickle Cell Clinic and associate hematologist/oncologist at UCSF Benioff Children’s Hospital Oakland, and colleagues wrote. “Further study is required to determine the impact of virtual reality therapy on opioid usage and length of stay in hospital.”

Marsh and colleagues sought to determine whether immersive virtual reality could be a feasible treatment approach for a cohort of 30 patients (median age, 16 years; 21 female) with sickle cell disease hospitalized for vasoocclusive pain episodes.

Results showed pain intensity dropped significantly after a single virtual reality session. Investigators observed improvement in sensory, affective, evaluative and temporal pain domains (P .01 for all).

There were no reported side effects, and all patients requested virtual reality therapy in the future, according to the researchers.

HemOnc Today spoke with Marsh about the study and the potential implications of the results.

Question: How did the idea for this research come about?

Answer: Simon Robertson, a volunteer at UCSF Benioff Children’s Hospital Oakland and founder of KindVR, approached the hematology/oncology department and inquired whether we could envision ways to utilize virtual reality to help our patients. Patients with sickle cell disease experience excruciating episodes of pain and often require hospitalization for IV opioids to help relieve pain and suffering. Opioids, although necessary, often are not sufficient. Recognizing the need for novel and accessible nonpharmacologic approaches to pain management, virtual reality seemed like a natural fit for our patients with sickle cell disease.

Q: How did you conduct the study?

A: We enrolled a convenience sample of 30 patients aged 8 years or older with sickle cell disease, all of whom were admitted with a vaso-occlusive pain episode. They participated in a session in which they were immersed in a calming virtual underwater world where they got to explore a marine environment. Patients completed a validated adolescent pediatric pain tool that described the severity, location and character of their pain, both before and after a 15-minute virtual reality session. Patients also completed a survey that assessed safety and acceptability of the session.

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Q: What did you find?

A: Virtual reality was well-tolerated and enthusiastically welcomed by the patients. Moreover, virtual reality decreased pain. The median pain score decreased from 7.3 prior to the virtual reality session to 5.8 afterward. The number of body areas where patients experienced pain dropped from three to two.

Q: How might this change practice?

A: We now have virtual reality headsets available in the hospital for routine clinical use. Virtual reality technology has the potential to be used much more widely in both the inpatient, outpatient and emergency room environments to help alleviate pain and anxiety.

Q: Do you have plans for additional research?

A: A clinical trial is underway at UCSF Benioff Children’s Hospital Oakland to evaluate whether virtual reality can help decrease pain and anxiety among pediatric oncology patients who have their mediport accessed in clinic. Additionally, we are studying virtual reality-simulated MRI sessions. If we can show — using a virtual reality-simulated MRI session — that a child is able to lie still for an MRI, we may be able to spare them exposure to anesthesia. – by Jennifer Southall

Reference:

Agrawal AK, et al. Pediatr Blood Cancer. 2019;doi:10.1002/pbc.27525.

For more information:

Anne Marsh, MD, can be reached at UCSF Benioff Children’s Hospital Oakland, 747 52nd St., Oakland, CA 94609; email: amarsh@mail.cho.org.

Disclosure: Marsh reports no relevant financial disclosures.