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A Virtual Reality Psychosocial Intervention for Patients Undergoing Bone Marrow Transplantation (BMT-VR): Pilot
Hermioni L Amonoo1,2,3, Richard Newcomb3,4, Riley Psenka4,5
11Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, MA.
Background:
Patients undergoing bone marrow transplantation (BMT) experience significant physical and psychological symptoms. Scalable psychosocial interventions to reduce distress and improve quality of life (QoL) are limited. Virtual reality (VR), with its 3-dimensional capabilities, offers a novel, scalable, patient-centered modality to address these needs.
Methods:
We randomized adult patients with hematologic malignancies undergoing autologous or allogeneic BMT to receive either a VR supportive care intervention (BMT-VR) or usual care during hospitalization. BMT-VR consists of 6 modules focused on: (1) psychoeducation and managing expectations; (2) psychosocial skill-building to promote coping; and (3) strategies to facilitate acceptance while facing uncertainty. The primary endpoint was feasibility (≥60% enrollment and ≥60% completion of ≥4 of 6 modules). Secondary outcomes included QoL (Functional Assessment of Cancer Therapy-Bone Marrow Transplant), depression and anxiety (Hospital Anxiety and Depression Scale), and posttraumatic stress disorder symptoms (Post-Traumatic Stress Disorder Checklist-Civilian Version) at baseline and at weeks 2, 4, 12, and 24 post-BMT. The System Usability Scale (≥80 indicates excellent usability) was administered at 4 weeks post-BMT.
Results:
Of eligible patients, 62.5% (85/136) consented and 59.6% (81/136) enrolled in the study (mean [SD] age, 57.9 [14.7] years; 51.9% female; 70.4% underwent allogeneic BMT). Among those assigned to BMT-VR, 64.1% completed ≥4 of 6 modules, exceeding feasibility benchmarks, and 69.2% (27/39) rated usability as excellent. After 4 weeks, patients assigned to BMT-VR reported improved QoL (108.2 vs 96.8; P=.014) and anxiety symptoms (3.6 vs 5.3; P=.016) versus usual care. No differences in depression or PTSD symptoms emerged at 4 weeks. Longitudinally, BMT-VR participants showed greater improvements in QoL (β = 3.8; P=.002), depression (β = -0.8; P<.001), and PTSD (β = -1.7; P=.006), but not in anxiety, compared with usual care.
Conclusions:
A VR-delivered psychosocial intervention is feasible during hospitalization for autologous or allogeneic BMT and shows promising preliminary effects on QoL and psychological outcomes. A future multisite trial is needed to assess efficacy for improving QoL and psychological distress in BMT recipients.
