Virtual reality distraction therapy
Topic Status Complete
Virtual reality therapy for the management of procedure-related pain.
Outcome of the appraisal
HTW undertook an evidence review to address the following question: what is the clinical and cost effectiveness of virtual reality (VR) as a distraction therapy for the management of procedural pain? Randomised trials of VR in a range of different clinical settings were identified, and used to estimate the effect of VR on pain during medical procedures. However, we did not identify any VR systems that are CE marked as medical devices for distraction therapy in order to minimise pain associated with medical procedures.
The HTW Assessment Group concluded that there are uncertainties regarding the regulatory approval of VR systems for use in the management of procedural pain, and given these uncertainties, HTW Guidance should not be produced at this time. Therefore, this topic will not progress to Appraisal Panel and will not receive HTW Guidance recommendations. If and when devices with relevant regulatory approval are available, this topic will be revisited.
Evidence Appraisal Report 017 gives a full report of the evidence on this topic.
Why was this topic appraised?
Common medical procedures often induce excessive pain, anxiety and distress to patients undergoing them. Examples include wound care, dressing changes, physical therapy for burns, dental treatment, chemotherapy, intravenous access, and labour. Pharmacological interventions can be used to minimise procedural pain, but these can have disadvantages, such as imprecise titration, narrow therapeutic windows, side effects, high costs and potential for drug misuse.
Distraction therapy (for example, exposure to music or video) is an alternative strategy for pain management during medical procedures associated with excessive amounts of pain. VR is an alternative to traditional methods of delivering distraction therapy to manage pain during procedures.
Plain language summary
Health Technology Wales (HTW) looked for evidence on the use of virtual reality (VR) as a distraction therapy in the management of pain experienced during medical procedures. Medical procedures such as having dental work, changing the dressings on wounds and burns and giving birth can cause patients to experience excess pain, distress and anxiety. This pain would usually be managed by providing pain medication. However, pain medication can be expensive and dosages can be difficult to calculate. Patients will often suffer from side effects and it can even lead to addiction. Distraction therapy is an alternative to using pain medication. During the medical procedure, exposure to things to ‘distract’ the patient by occupying their attention, such as playing music and movies, can help to reduce pain, anxiety and distress.
VR is where the sights, sounds and sometimes the feel of an environment is simulated by technology so that it can be experienced and interacted with. A person who uses a VR device can have the experience of being somewhere, like the beach, when they are actually somewhere else, such as in hospital. This is made possible by wearing a head mounted device, like a helmet, that projects the images and sounds of a chosen environment. It is proposed that VR can be used in this way during medical procedures to reduce the pain experienced by the patient.
There are many different types of VR devices that can be used in this way and their effectiveness in reducing pain may vary, but overall the evidence shows that VR appears to be effective at reducing pain during medical procedures compared to traditional methods of pain management. However, to the best of our knowledge no VR devices have yet been certified as meeting health, safety and environmental standards for use in pain management. Therefore, HTW will not be producing guidance on their use at this present time.