A Personalized Approach Using an N-of-1 Trial of Virtual Reality Hypnosis for Persistent Dyspnea

Area of Science:

• Pulmonary Medicine
• Digital Health
• Personalized Medicine

Background:

• Persistent dyspnea significantly impacts quality of life in chronic obstructive pulmonary disease (COPD) patients.
• Individual variability in treatment response necessitates personalized therapeutic strategies.
• Conventional treatments for dyspnea in COPD may be insufficient for some patients.

Purpose of the Study:

• To evaluate the efficacy of virtual reality hypnosis (VRH) in managing persistent dyspnea in COPD patients using N-of-1 trials.
• To explore the potential of VRH as a personalized intervention for refractory dyspnea.
• To inform individualized treatment decisions by assessing patient-specific responses to VRH.

Main Methods:

• Conducted N-of-1 trials with two COPD patients experiencing persistent dyspnea.
• Employed a counterbalanced design with four 2-day periods, alternating between VRH and a distractive virtual reality (drone ride).
• Assessed outcomes using patient-generated questionnaires on a 6-point Likert scale.

Main Results:

• One patient experienced significant reductions in dyspnea intensity and improved well-being with VRH.
• The second patient reported enhanced well-being but no significant change in dyspnea intensity during VRH.
• N-of-1 trials demonstrated individual variability in response to VRH therapy.

Conclusions:

• N-of-1 trials are effective for evaluating personalized treatment efficacy in COPD patients with persistent dyspnea.
• VRH shows potential as a tailored therapy for managing dyspnea, with outcomes varying by individual.
• Integrating N-of-1 trials for alternative therapies in dyspnea clinics can optimize patient outcomes and satisfaction.