Barriers and facilitators to the implementation of virtual reality interventions for people with chronic pain: a scoping review (Preprint)

Abstract

Chronic pain is a growing health problem worldwide, with a significant impact on individuals and societies. In regards to treatment, there is a gap between guideline recommendations and common practice in healthcare, especially concerning cognitive and psychological interventions. Virtual reality (VR) may provide a way to improve this situation. A growing body of evidence indicates that VR therapy has positive effects on pain and physical function. However, there is limited knowledge about barriers and facilitators to the implementation of VR interventions for people with chronic pain in health care settings.

This study aims to identify and analyze barriers and facilitators to implementing VR interventions for people with chronic pain.

We conducted a scoping review of German and English articles using MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, PEDro, LILACS and Web of Science (inception to November 2023), including quantitative, qualitative and mixed methods studies reporting barriers and facilitators to the implementation of VR interventions for people with chronic pain, reported by patients or health care professionals. Two reviewers systematically screened the abstracts and full texts for inclusion criteria and then extracted and categorized all barriers and facilitators according to the Theoretical Domains Framework (TDF).

The database search resulted in 1864 records after removal of duplicates. From 14 included studies 30 barriers and 33 facilitators from the patient perspective and 2 facilitators from the health care professional perspective were extracted. Barriers reported by people with chronic pain were most frequently assigned to the TDF domains environmental context (60%) and skills (16.7%). Most facilitators were found in the domains beliefs about consequences (30.3%), emotions and environmental context (18.2% each), which were also the facilitators reported by health care professionals.

Future implementations of VR interventions for people with chronic pain should use the findings of the review as a basis to develop an implementation strategy. Additionally, further research should address knowledge gaps about perspective of health care professionals regarding the implementation of VR intervention for people with chronic pain.