Social Virtual Reality Experiences for Hospitalized Older Adult Trauma Patients to Reduce Pain

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Older adults (i.e., those 65 years of age and older) account for more than 25% of all US hospital trauma admissions, primarily due to falls and collisions. Given the aging population of the US, by 2050, approximately 40% of all trauma patients are estimated to be over the age of 65. Trauma patients experience high rates of pain. Opioid medications are commonly used to manage trauma-related pain, but contribute to excess morbidity, including risk of addiction, delirium occurrence, constipation, and falls. In addition, adverse events resulting from opioid use increase hospital length-of stay, overall costs, risk of infection, and delays outpatient rehabilitation. Multiple authorities have called for the development and testing of nonpharmacologic pain mitigation approaches in this population, but few are in use. To address this gap, we propose to evaluate a novel pain treatment, social virtual reality (SVR), in older adult trauma patients, in a two-step study to examine feasibility, usability, and acceptability for patients, their friends and family, and, as a secondary measure, clinicians who are involved in patient care. We will present existing versions of SVR to 10-15 patients, interview them, and make iterative refinements according to their feedback. In the second part of this study, we will conduct an uncontrolled pilot study with 25-30 older hospitalized patients, to establish the feasibility, usability, and acceptability of SVR, and of data collection protocols and data availability to capture differences pain, anxiety and mood. Patients will identify a “partner,” a family member or close friend, with whom they would like to experience SVR, and a research assistant (RA) will provide headsets and intensive technical support for both patient and partner. We will assess feasibility, usability and acceptability through successful recruitment and completion of the study protocol, as well as through surveys using standard measures of usability and acceptability for both groups: patients and partner. We will also examine differences in patient pain, anxiety, and mood, measuring these outcomes pre- and post-intervention by survey as well as using a method of ecological momentary assessment based on surveys in the headset and tracking user data.