A Randomized Clinical Trial of Smartphone Virtual Reality for Pain Management During Burn Care Transition
The use of a virtual reality app has the potential to be a cost-effective way to alleviate pain, reduce the need for opioids, and improve outcomes for children needing at-home dressing changes for burn injuries.
Project Details -
Ongoing
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Grant NumberR01 HS029183
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Funding Mechanism(s)
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AHRQ Funded Amount$1,875,424
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Principal Investigator(s)
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Organization
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LocationColumbusOhio
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Project Dates09/30/2022 - 07/31/2027
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Technology
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Care Setting
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Medical Condition
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Population
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Type of Care
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Health Care Theme
Burns injure over 114,000 children in the United States each year, representing one of the leading causes of injury in children. Over half of pediatric burn injuries seen in emergency departments result in transfers to a burn center. These patients frequently return home requiring ongoing wound care with dressing changes for open wounds, which can be extremely painful, often requiring opioids. Pain perception requires cognitive attention. Using virtual reality (VR) technology interrupts the cognitive route from pain origin to perception: that is, distracting a person’s attention away from pain reduces the perception of that pain. This is opposed to opioids that reduce pain by blocking pain receptors. VR’s immersive environment may also result in a calming effect with a reduction in anxiety. While VR for pain management has been studied and is effective, using smartphones for VR has not.
This research will employ and evaluate smartphone VR for pediatric burn injuries to improve pain during dressing changes and outcomes. The researchers previously developed the VR Pain Alleviation Tool (VR-PAT): this followup work will evaluate the effectiveness of VR-PAT for pain management and reduction in need for opioids, and identify facilitators and barriers impacting the use of VR-PAT. The researchers anticipate that VR-PAT will reduce pain by greater than 30 percent during home burn dressing changes.
The specific aims of the research are as follows:
- Evaluate effectiveness of VR-PAT for pain management and opioid pain medication reduction during at-home burn care.
- Examine continuous engagement of patients and caregivers with VR-PAT during repeated at-home burn dressing changes.
A randomized clinical trial will include 200 pediatric burn patients ages 6-17. Dressing changes will occur at home with the intervention group using VR-PAT, and the control group using standard care. A standardized pain scale, the Numerical Rating Scale (NRS), will measure overall pain and worse pain during each dressing change over 1 week. The pain intensity and opioid consumption (PIOC) score will be calculated as the primary outcome for the first aim. Adverse events, VR experience and engagement will be measured in the VR group to determine challenges in this smartphone-based intervention.
This approach offers the potential for a safe, easily disseminated, non-opioid pain management approach for children needing dressing changes for burn injuries.
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