Mo, Jiping; Vickerstaff, Victoria; Minton, Ollie; Tavabie, Simon; Taubert, Mark; Stone, Paddy; White, Nicola; (2022) How effective is virtual reality technology in palliative care? A systematic review and meta-analysis. Presented at: Marie Curie Research Conference 2022, Virtual conference.

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Abstract

Introduction: Virtual Reality (VR) has the potential to alleviate common mental and physical health symptoms at the end-of-life. There is limited data on the efficacy of VR in palliative care. Aims To review the feasibility and effectiveness of VR intervention within a palliative care setting. / Method: Medline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception up to March 2021. Studies that reported on the use of VR in an adult (over 18 years) palliative population were included. The ROB-2 (for RCTs) and ROBINS tools (for non-RCTs) were used to assess risk of bias. The GRADE tool assessed the quality of the evidence. Data regarding feasibility, acceptability, and changes of psychological and physical symptoms of palliative care patients were extracted. Standardised mean differences (Hedges’ g) were calculated from the pre- post data reported on patient outcomes. A DerSimonian-Laird random effects model meta-analysis was conducted. PROSPERO (CRD42021240395, 03/03/2021). / Results: 524 studies were identified; 8 studies were included, 5 were included in the meta-analysis. All studies had at least some concern for risk of bias. 44% (97/219) of patients were male; the mean age ranged from 47 to 85 (years). Recruitment was feasible and retention rates ranged between 55% and 100%. Discomfort and technical issues were recorded in 4/7 studies (57%) but overall, participants reported a positive experience. The meta-analysis showed VR statistically significantly improved pain (p=0.0363), tiredness (p=0.0030), drowsiness (p=0.0051), shortness of breath (p=0.0284), depression (p=0.0091), and psychological well-being (p=0.0201). The quality of the evidence was graded as low to very low. / Conclusion: VR in palliative care is feasible and acceptable. Larger trials with a control arm are needed. Impact VR could be an adjuvant non-pharmacological therapy for symptoms such as anxiety, pain, or depression. Higher quality studies are needed to inform clinical recommendations.

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