Virtual Reality as RESPITE: Relief Exploration for Sickle Pain Through Interventions Using Technology Engagement: A Hospital-Based Observational Study

Background: The opioid epidemic, side effects from acute and chronic opioid use, and low utilization of preventive medications for sickle cell disease (SCD) necessitate the development of novel strategies to manage painful vaso-occlusive episodes. Virtual reality (VR) has shown promise for pediatric patients with SCD; however, interest in VR among adults with SCD is under examined. Ensuring equitable access to VR-based interventions requires understanding of factors that determine patients' interest in VR.

Objective: To assess interest, preferences, and predictors regarding interest in VR-based interventions to manage SCD-related pain.

Design: Cross-sectional, observational, single-site study conducted between 2023 and 2024.

Participants: Hospitalized, English-speaking, had a SCD diagnosis, and aged ≥ 18 years.

Main Measures: The primary outcome was participants' interest in using VR. General health literacy (HL) and electronic health literacy (eHL) were assessed using Brief Health Literacy Screen and eHealth Literacy Scale, respectively, to compare differences between participants interested versus uninterested in using VR to manage pain. Participants also indicated preferred gaming genres and barriers to VR use.

Key Results: Among 40 participants (80% response rate), most self-identified as Black (95%) and male (58%); 43% had low HL; and 13% had low eHL. Most (85%) participants indicated interest in using VR for pain management (n = 34/40). Participants uninterested in using VR were more likely to have low HL (100% vs. 33%; p = 0.002) and low eHL (67% vs. 3%; p < 0.001) than participants interested in VR. Skill development (82%; e.g., learning how to rock-climb) and adventure (82%) genres were most preferred among interested participants. Cost (65%) and access to VR devices (35%) were cited as notable barriers.

Conclusions: The present study identifies that people with SCD regard VR as a promising intervention for pain management. Future studies include designing equitably accessible VR interventions and assessing efficacy, paying attention to factors like electronic and general health literacy.