title: Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial.
abstract: BACKGROUND
  Improvements in software and design and reduction in cost have made virtual reality (VR) a practical tool for immersive, three-dimensional (3D), multisensory experiences that distract patients from painful stimuli.
  
  
  OBJECTIVE
  The objective of the study was to measure the impact of a onetime 3D VR intervention versus a two-dimensional (2D) distraction video for pain in hospitalized patients.
  
  
  METHODS
  We conducted a comparative cohort study in a large, urban teaching hospital in medical inpatients with an average pain score of ≥3/10 from any cause. Patients with nausea, vomiting, dementia, motion sickness, stroke, seizure, and epilepsy and those placed in isolation were excluded. Patients in the intervention cohort viewed a 3D VR experience designed to reduce pain using the Samsung Gear Oculus VR headset; control patients viewed a high-definition, 2D nature video on a 14-inch bedside screen. Pre- and postintervention pain scores were recorded. Difference-in-difference scores and the proportion achieving a half standard deviation pain response were compared between groups.
  
  
  RESULTS
  There were 50 subjects per cohort (N=100). The mean pain reduction in the VR cohort was greater than in controls (-1.3 vs -0.6 points, respectively; P=.008). A total of 35 (65%) patients in the VR cohort achieved a pain response versus 40% of controls (P=.01; number needed to treat=4). No adverse events were reported from VR.
  
  
  CONCLUSIONS
  Use of VR in hospitalized patients significantly reduces pain versus a control distraction condition. These results indicate that VR is an effective and safe adjunctive therapy for pain management in the acute inpatient setting; future randomized trials should confirm benefit with different visualizations and exposure periods.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT02456987; https://clinicaltrials.gov/ct2/show/NCT02456987 (Archived by WebCite at http://www.webcitation.org/6pJ1P644S).
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
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authors.identifier: http://orcid.org/0000-0002-2377-7723
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authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
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authors.identifier: http://orcid.org/0000-0002-1976-3943
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authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
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authors.identifier: http://orcid.org/0000-0001-8008-3851
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authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
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authors.identifier: http://orcid.org/0000-0001-5897-2679
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authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Taylor
authors.identifier: http://orcid.org/0000-0002-3702-0377
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authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
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authors.identifier: http://orcid.org/0000-0002-1942-225X
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authors.lastname: Reid
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Bibiana
authors.identifier: http://orcid.org/0000-0002-8777-1582
authors.initials: B
authors.lastname: Martinez
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Shahzad
authors.identifier: http://orcid.org/0000-0001-9515-2194
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Francis
authors.identifier: http://orcid.org/0000-0001-8353-0709
authors.initials: F
authors.lastname: Dailey
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Karen
authors.identifier: http://orcid.org/0000-0001-8395-0826
authors.initials: K
authors.lastname: Robbins
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Bradley
authors.identifier: http://orcid.org/0000-0001-5833-7341
authors.initials: B
authors.lastname: Rosen
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Garth
authors.identifier: http://orcid.org/0000-0003-4977-7833
authors.initials: G
authors.lastname: Fuller
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Itai
authors.identifier: http://orcid.org/0000-0001-9580-6450
authors.initials: I
authors.lastname: Danovitch
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Waguih
authors.identifier: http://orcid.org/0000-0003-1970-4756
authors.initials: W
authors.lastname: IsHak
authors.affiliation: Cedars-Sinai Medical Center, Health Services Research, Los Angeles,CA, CA, United States.
authors.forename: Brennan
authors.identifier: http://orcid.org/0000-0002-4608-6896
authors.initials: B
authors.lastname: Spiegel
keywords: hospitalization; inpatients; pain; virtual reality