S929 Assessment of Virtual Reality on Pain and Anxiety at an Infusion Clinic Setting in Patients With Inflammatory Bowel Disease: A Pilot Acceptability Study

Abstract

Introduction: Inflammatory Bowel Disease (IBD) is a chronic relapsing and remitting inflammatory condition of the bowel lumen. While abdominal pain is most severe when acute inflammation is present, many patients with IBD in endoscopic remission continue to have abdominal pain. Psychological conditions like anxiety may exacerbate symptoms and cause more frequent flares, leading to increased hospitalizations. Non-pharmacological methods such as virtual reality (VR) have been shown to decrease pain and anxiety in inpatient settings. While there has been support of VR in IBD patients in an clinic setting, no studies have assessed the use of VR in IBD patients at infusion centers, an important aspect of IBD management. If VR can improve both pain and anxiety, then it may lead to improved health outcomes. Methods: This is a prospective, single-center, paired-sample study of adult patients with IBD, where pain and anxiety were measured before and after their regular infusion clinic appointment, with the use of VR on their following infusion appointment. At the end of the study, there was an assessment of the feasibility of VR for future encounters. Anxiety was measured using the Beck Anxiety Inventory (BAI), and pain was measured using the Short-Form McGill Pain Questionnaire (SF-MPQ). The VR headset included immersive options such as guided meditations and deep sea diving, and prohibited content that would cause potential distress. Paired sample t-tests were utilized to compare any differences in pain or anxiety during their infusion therapy, with and without use of virtual reality. Results: In this pilot study, we report data of 14 adult patients with IBD (57% Crohn’s Disease, 43% Ulcerative Colitis). Mean age was 42.07 years. Demographic, BAI, SF-MPQ, and VR feasibility data are shown in Table (Table). Conclusion: While preliminary analyses show VR had no significant change in BAI (t = -0.244, p-value = 0.405) and SF-MPQ (t = -0.336, p-value = 0.371), participants reported positive experiences with VR. Patients rated their experience an average of 7.79 on a scale of 1 to 9. 71% of patients reported they would like to use VR during future appointments. These finding support the acceptability of VR in an infusion clinic setting, and provide a framework for further assessment of pain and anxiety in future larger randomized control trials. Table 1. - VR IBD Group Data Age Mean 42.07 years Sex • Male • Female 8 (57%)6 (43%) IBD Type • Crohn’s Disease • Ulcerative Colitis 8 (57%)6 (43%) Infusion Medication • Infliximab • Vedolizumab 7 (50%)7 (50%) Percent of Time with VR During Infusion • Total • Infliximab • Vedolizumab Mean: 74%Mean: 50%Mean: 98% Chronic Opioid Use 2 (14%) Pharmacologic Therapy for Anxiety 4 (29%) Nonprescription Therapy for Anxiety/Pain 5 (36%) Beck Anxiety Inventory (BAI) t = -0.244, p-value = 0.405 Short Form McGill Pain Questionnaire (SF-MPQ) t = -0.336, p-value = 0.371 Would Like to Use VR During Future Appointments 10 (71%) Rate Your Experience1 (Dislike) to 5 (Indifferent) to 9 (Enjoyed) Mean: 7.79 Infusion Experience Felt Faster with VR 12 (86%) Forgot was in Infusion Clinic with VR 3 (21%)