Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 11, 2023
Open Peer Review Period: Aug 10, 2023 - Oct 5, 2023
Date Accepted: Nov 27, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
VRCT: Randomized Controlled Trial Evaluating the Impact of Virtual Reality on behavioral and Psychological Symptoms and Quality of Life of Acute Care Inpatients with Dementia
ABSTRACT
Background:
Virtual Reality (VR) is increasingly considered a valuable therapy tool for people with dementia. However, rigorous studies are still needed to evaluate its impact on behavioral and psychological symptoms of dementia (BPSD) and quality of life (QoL) across care settings.
Objective:
The primary aim of this study was to evaluate the impact of VR-therapy on managing BPSD, falls, length of stay (LoS), and QoL for inpatients with dementia admitted to an acute care hospital. The secondary aim was to evaluate the intervention’s feasibility in terms of acceptability, safety, and patient experience.
Methods:
A prospective, open-label, mixed-methods, randomized controlled clinical trial was conducted between April 2019 and March 2020. A total of 69 participants (age ≥ 65, diagnosis of dementia, who did not meet exclusion criteria) were randomly assigned to either the Control (n = 35) or VRx (n = 34) arm. Participants in the experimental (VRx) arm (n=35) watched 360-degree VR-films in a head-mounted display for up to 20 minutes, every 1-3 days, while individuals in the control arm (n=34) received standard of care. Instances of daily BPSD and falls were collected from nurses’ daily notes. QoL was measured through semi-structured interviews and The Quality of Life in Late-Stage Dementia scale. Structured observations and semi-structured interviews were used to measure treatment feasibility. Primary outcomes were analyzed at a 95% significance level, based on the Intention-to-Treat method.
Results:
VR-therapy had a statistically significant effect in reducing aggressiveness (i.e., physical aggression and loud vociferation). No statistically significant impact of VR-therapy was found for other BPSD (e.g., apathy), falls, LoS, or QoL as measured through the QUALID scale. The average VR-therapy session lasted 6.8 minutes (range 0-20 minutes) and the intervention was overall an acceptable and enjoyable experience for participants. No adverse events occurred as a result of VR-therapy.
Conclusions:
Immersive VR-therapy appears to have an effect on aggressive behaviors in acute care patients with dementia. Although the RCT was stopped before reaching the intended sample size due to COVID-19 restrictions, trends in the results are promising. We suggest conducting future trials with larger samples and, in some cases, more sensitive data collection instruments. Clinical Trial: ClinicalTrials.gov NCT03941119 https://classic.clinicaltrials.gov/ct2/show/NCT03941119
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.