University of Maryland, Baltimore
This randomized pilot study will evaluate the feasibility, tolerability, and preliminary analgesic effect of headset-based virtual reality (VR) interventions for adults with sickle cell disease (SCD) experiencing vaso-occlusive crisis (VOC) treated in an infusion center. Up to 50 participants will be enrolled, provide informed consent, and undergo randomization during routine outpatient sickle cell clinic visits when they are clinically stable and not experiencing an acute VOC. Using a randomized, two-period crossover design, each participant will be assigned to receive two of three headset-based interventions during separate qualifying infusion center visits for vaso-occlusive pain occurring within six months of enrollment: sham 2D headset control, passive immersive 3D VR, or active immersive interactive 3D VR. Each intervention will be delivered during a 45-minute session as an adjunct to usual clinical care. The primary outcome is pain burden during the first 60 minutes after intervention start, measured as the area under the curve of 0-10 numeric rating scale pain scores. Secondary outcomes include feasibility of intervention delivery, headset tolerability, pain at 120 minutes, opioid consumption, and participant-reported immersion and acceptability. Findings will inform the design of future trials evaluating VR as an adjunctive treatment for acute vaso-occlusive pain.
Vaso-occlusive crisis (VOC) is a common and debilitating complication of sickle cell disease (SCD) and is a frequent reason for treatment in acute care settings, including infusion centers and emergency departments. Opioid analgesics remain the mainstay of treatment for acute vaso-occlusive pain, but many patients continue to experience substantial pain, distress, and functional impairment despite standard therapy. Scalable, low-risk, non-pharmacologic adjuncts are needed to improve pain management during acute vaso-occlusive episodes. Virtual reality (VR) is a promising non-pharmacologic app…
Participants will be identified, screened, and consented during routine outpatient sickle cell disease clinic visits when they are clinically stable and not experiencing an acute vaso-occlusive crisis (VOC). Following enrollment, eligibility for each study intervention session will be confirmed during a qualifying VOC visit to the Stoler Infusion Center. Participants must meet the applicable clinical eligibility criteria and be receiving intravenous opioid treatment for acute vaso-occlusive pain at the time of the intervention visit. \*\*Inclusion Criteria:\*\* * Adult patients aged 18 years…
The sham 2D headset control condition consists of non-interactive, two-dimensional nature-related video content displayed on a fixed virtual screen using the Meta Quest 2 headset platform. The content will be presented through the YouTube application and will depict natural environments similar to those used in the immersive VR conditions. Standardized audio will accompany the visual content. Participants will wear the headset for a planned 45-minute session during a qualifying vaso-occlusive crisis infusion center visit. This condition serves as a headset-based control to maintain similar device exposure and attention across intervention conditions while minimizing immersion and interactivity.
The passive immersive 3D virtual reality condition consists of immersive three-dimensional visual content delivered through the Nature Treks application using the Meta Quest 2 headset platform. Participants will experience immersive natural environments with standardized audio and may look around the virtual environment but will not interact with the content using controllers. Participants will wear the headset for a planned 45-minute session during a qualifying vaso-occlusive crisis infusion center visit. The intervention will be provided as an adjunct to usual clinical care.
The active immersive interactive 3D virtual reality condition consists of immersive, interactive three-dimensional content delivered through the Nature Treks application using the Meta Quest 2 headset platform. Participants will experience immersive natural environments with standardized audio and interact with the virtual environment using handheld controllers while completing low-motion, seated activities. Participants will wear the headset for a planned 45-minute session during a qualifying vaso-occlusive crisis infusion center visit. The intervention will be provided as an adjunct to usual clinical care.