The Feasibility and Acceptability of a Stand-Alone Virtual Reality Headset on Perceived Pain and Anxiety During Bone Marrow Biopsies: A Mixed Methods Study (Preprint)

Abstract

BACKGROUND Virtual Reality (VR) is an emerging technology that provides an immersive user experience and has the ability to distract patients from the negative or painful experiences commonly associated with medical procedures. Bone marrow biopsies are medical procedures where a needle is inserted into the bone and a syringe is used to withdraw the liquid bone marrow. They are performed to diagnose and monitor disorders affecting the blood, often as part of care for hematology and oncology patients. OBJECTIVE The purpose of this pilot study is to assess the feasibility of VR as an adjunctive therapy to alleviate the perception of pain and anxiety in patients receiving bone marrow biopsies. METHODS This pilot study enrolled 60 adult participants receiving a bone marrow biopsy to assess the acceptability and feasibility of virtual reality to impact reported pain & anxiety levels compared to the subject’s baseline measurements pre-operatively. They were randomly assigned into ‘control’/non-VR intervention (n = 30) and ‘experimental’/VR groups (n = 30). The ‘experimental’/VR group utilized the Meta Quest 2 headset (Meta, Menlo Park CA) with original VR content developed for this study. Participants completed a survey adapted from a standardized verbal numerical rating score (VNRS) to rate their pain and anxiety levels before and after the bone marrow biopsy. Measurements such as procedure length, patient vitals, and experience were also gathered from both study groups. RESULTS Results indicated that participants had no significant differences in their heart rate, respiration rate, and blood oxygen saturation levels between the two groups. Participants in the VR group had a significantly shorter procedure length than the control group. Participants in the VR group were significantly more likely to rate the distraction as effective and report they would repeat the procedure. Finally, participants in the VR group had significantly lower levels of anxiety before the procedure and felt significantly more comfortable after the procedure. CONCLUSIONS This investigation encourages the acceptability of using VR intervention for patients undergoing bone marrow biopsies. Further, the length of procedures were found to be shorter when compared to the control group - supporting the feasibility of the technology for clinical management. These novel interventions can provide distraction-based therapy that is non-inferior to standard of care and provide enjoyable user experiences which reduce the perceived pain & anxiety of non-sedated medical procedures. CLINICALTRIAL International Registered Report Identifier (IRRID): DERR1-10.2196/52649