Recall of psychotherapy information and immersiveness in a virtual reality application for cancer-related chronic pain

Introduction: There is increasing interest in the use of virtual reality (VR) as a modality to provide health interventions to patients. An unmet need in patients with cancer-related chronic pain is the availability of effective nondrug, pain psychology-based therapies that improve function and quality of life. To address this need, we previously created a custom-made VR program that teaches how to self-administer progressive muscle relaxation and guided pain visualization therapy in patients with cancer. We sought to determine if knowledge retrieval of these therapies is affected when comparing the same content delivered via a VR head-mounted display and hand motion controllers (“VR group”) or via 2D monitor and keyboard/mouse on a traditional personal computer (“PC Monitor group”). Methods: Randomized controlled study of healthy volunteers divided into VR group and Monitor group. Primary outcome was multiple-choice question scores between groups at two time periods (immediately after use and 2 weeks follow-up) testing knowledge recall of the therapies. Secondary outcomes were levels of immersion and satisfaction. Results: Forty healthy adults were recruited. Participants rated the VR-based version as highly immersive compared with the PC Monitor version (p < 0.001). There was no difference in knowledge retrieval both between groups (p = 0.98) and within groups (p = 0.58) after adjusting for age, education, and video game experience. Both the VR and PC groups had no quantitative difference in satisfaction (p values all >0.06) but qualitatively preferred the VR for clinical use despite more feedback on cybersickness side effects. Conclusion: This study provided further evidence on how to implement VR in clinical settings to improve acceptability and equivalency to traditional methods of chronic pain education.