Virtual reality therapy for the management of procedure-related pain

Health Technology Wales
Record ID 32018000709
English
Authors' objectives: 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?
Authors' results and conclusions: HTW identified 40 RCTs (covering a population of 2501 patients) and used these to carry out metaanalysis on the effect of VR on pain-related outcomes during medical procedures. The results indicated that VR distraction therapy was more effective than usual care in reducing pain during or immediately after the procedure. The trials included in the analysis covered a range of different medical procedures. Subgroup analysis showed that regardless of the medical procedure the VR intervention shows a positive effect on pain outcomes. Similarly, subgroup analysis showed VR had similar levels of effectiveness in adults and in children. We also looked for evidence of any adverse events associated with using VR in this way: nausea was very infrequent and mild and no other adverse events were reported. However, statistical analysis uncovered evidence suggestive of publication bias in the available evidence. The methods of measuring pain used in the trials also pose difficulties in translating the results into clinically significant changes in pain. The trials identified used commercially available VR systems that are not explicitly covered by medical device regulations. We did not identify any trials that used a VR system that is CE-marked for use as a medical device for the management of pain associated with medical procedures, nor are we aware of the existence of any such devices. No economic evidence was identified on the use of VR distraction therapy in people at risk of pain cause by medical procedures. VR used in this way has the potential to be cost saving if it shows demonstrable reductions in opioid utilization and/or hospital length of stay. However, we did not identify any evidence on how the use VR influences these outcomes.
Authors' methods: The Evidence Appraisal Report is based on a literature search (strategy available on request) for published clinical and economic evidence on the health technology of interest. It is not a full systematic review but aims to identify the best available evidence on the health technology of interest. Researchers critically evaluate and synthesise this evidence. We include the following clinical evidence in order of priority: systematic reviews; randomised trials; non-randomised trials. We only include evidence for “lower priority” evidence where outcomes are not reported by a “higher priority” source. We also search for economic evaluations or original research that can form the basis of an assessment of costs/cost comparison. We carry out various levels of economic evaluation, according to the evidence that is available to inform this.
Details
Project Status: Completed
Year Published: 2020
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: Wales, United Kingdom
MeSH Terms
  • Virtual Reality
  • Pain Management
  • Pain
  • Analgesia
  • Ambulatory Care
  • Pain, Procedural
Keywords
  • Virtual reality
  • Pain
  • Outpatient procedures
  • Analgesia
Contact
Organisation Name: Health Technology Wales
Contact Address: Life Sciences Hub Wales 3 Assembly Square Cardiff CF10 4PL
Contact Name: Susan Myles, PhD
Contact Email: healthtechnology@wales.nhs.uk
Copyright: Health Technology Wales
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.