Virtual Reality Helps Alleviate Pain Among Burn Injury Patients

Virtual reality (VR) technologies are effective in distracting burn injury patients from pain, according to recent research published in PLOS Digital Health.

United States burn centers commonly rely on medications like opioids for pain management. But, amid the ongoing opioid epidemic, researchers are examining non-pharmaceutical interventions to bolster pain management efforts.

For this study, researchers aimed to examine the use of VR in alleviating pain resulting from dressing changes for burn injuries. They conducted a three-group pilot randomized clinical trial designed to test the feasibility and efficacy of a smartphone-based VR pain alleviation treatment (VR-PAT) in reducing self-reported pain of burn injury patients.

Researchers recruited adult patients with burn injuries between May 2019 and February 2020 from an American Burn Association-verified burn center. They were randomly assigned to one of the following treatment arms: active VR, passive VR, or standard of care.

The active VR group played a series of four VR games specifically designed for the study, the passive VR group toured the same virtual environments as the active VR group but was not presented with any of the interactive elements of the games, and the standard care group received common distraction tools like music.

Study participants were 18 to 70 years old, had received their burn injury four or fewer days ago, were admitted to an inpatient setting for acute burn injury for the first time, required multiple dressing changes, and used opioids for dressing changes.

Thirty-three patients were eligible for the study, of which 14 agreed to participate. Among the 14, four were assigned to the active VR group, four to the passive VR group, and six to the control group.

The study shows that average self-reported pain was lowest among participants in the active VR group and highest among those in the passive VR group across three dressing changes. Additionally, the average self-reported ‘worst’ pain was lowest among the active VR group during the first and last dressing change, but the control group had the lowest self-reported ‘worst’ pain at the second dressing change.

The time to complete the first two dressing changes was longer for the control group than for the active and passive groups. However, the control group used the least opioids for the first two changes, while the passive group used the most opioids for those dressing changes.

“While this study had a small sample size caused by the patient recruitment interruption due to COVID-19, the preliminary results suggest that patients in the active VR group experienced less pain than those in the passive VR and control groups,” the researchers concluded.

Researchers are examining the potential utility of VR technology in other healthcare-related use cases as well.

For instance, in August, University of Texas Austin (UT Austin) researchers announced that they had modified a commercial VR headset to measure brain activity and better understand how humans react to stressors and other outside factors.

The team developed a noninvasive electroencephalogram (EEG) sensor that they added to a Meta VR headset. The EEG measures the user's brain activity during VR interactions. The technology could be used to help manage anxiety and measure mental stress.

As a result of the growing use of VR in healthcare, the Centers for Medicare and Medicaid Services (CMS) established a unique Healthcare Common Procedure Coding System (HCPCS) Level II code for a virtual reality program in March.

The new HCPCS Level II code categorizes AppliedVR’s RelieVRx program as durable medical equipment (DME), making it the first digital therapeutic to be placed in an existing benefit category, according to the press release.

Establishing the code creates a more definitive pathway for the solution to secure Medicare coverage eligibility.