There is a significant need for medical treatment in developing countries. The unavoidable pain that accompanies procedures is sub-optimally controlled for many reasons. A significant amount of research has been done on the use of Immersive Virtual Reality Therapy (IVRT) to reduce pain and anxiety relating to procedures. Having been on several medical service trips, I believe that mobile VR could help manage acute pain in certain situations. It has been used at least once before by a surgeon treating patients in rural areas of Mexico.
The challenge of acute pain in developing countries
An article by the International Association of the Study of Pain discussed the challenges around acute pain in developing countries. There are several barriers to treating pain: shortage of trained healthcare professionals, low supply of pain medications due to cost, language differences, cultural barriers, lack of equipment/facilities, and patient stoicism.
There are several areas where acute pain is particularly challenging: postoperative pain, pain of childbirth, pain during pediatric procedures, and pain management in the emergency department. When it comes to childbirth epidurals, a standard of care in developed countries, are rarely performed due to expense and trained provider needed for the procedure. Millions of children in developing countries undergo surgery annually and have been shown to benefit from supportive care measures such as play therapy.
The research behind VR for pain relief
Over 80 research studies have been conducted on the use of Immersive Virtual Reality Therapy (IVRT) to distract patients from painful and anxiety provoking procedures. The first VR pain relief program was made at the University of Washington in Seattle back in the year 2000. Since then, several randomized control trials have been published and recently the trials done in hospitals were systematically reviewed.
It has been used in several situations including: fibromyalgia, chronic back/neck/neuropathic pain, supportive therapy at chronic pain centers, movement related pain in trauma patients, wound dressing changes with burn victims, post-stroke pain, IV access, infusion of chemo, port access, colonoscopy, lumbar punctures, episiotomies, dental treatment, and many more.
Though Immersive Virtual Reality Therapy for pain relief is one of the more well researched VR use cases within healthcare, larger studies are still needed. As the field develops and more organizations get involved we will see a large multi-center clinical trial similar to what is seen with surgical or drug based treatments.
Proposal for IVRT use for medical service trips
Thousands of healthcare providers around the world volunteer their time to provide medical services in developing countries. Luckily a large portion of these providers bring their smart phones with them to use when possible during their stay.
The quality of the VR programs that were found to be clinically beneficial five years ago can now be done on almost any smartphone with a free google cardboard headset. However, there are only a few programs on google Cardboard that might be useful in a pilot study. There are far more quality programs on Samsung Gear VR and Google Daydream, but healthcare volunteers may not have the right phones for those platforms. No matter which one more programs tailored to clinical situations would be beneficial.
There are understandably limits to its use in developing countries. The main limitation will be when the healthcare team is able to use electricity. Many medical NGOs will house volunteers at a compound that will have electricity at night and transport them to more rural area for service. In the right setting these portable VR platforms could help those in resource limited areas.
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