A look at how virtual reality is making an impact on pharmacists and patient care.
As an industry, virtual reality (VR) has moved far beyond a tool for gaming and entertainment: Over the last decade, VR—a market with a global value of $17.25 billion in 2020 and an anticipated growth to $184.66 billion by 20261—has gained a foothold within the larger health care industry. VR simulation is being used for everything from medical education to pain management to rehabilitation.
Pharmacists—and the pharmaceutical industry—are also learning just how VR can make a difference, as well as the significant role it can play in patient care.
Mary Youssef, PharmD, RPh, a mobile IV infusion therapist for HealthIV, noted that pharmacies and pharmacists have been exploring the possibility of better workplace accuracy and efficiency for years. This has slowly led to the study of VR in the burgeoning pharmacy field.
VR technology in health care grew from the desire to create immersive sensory experiences in virtual environments. This sensory delivery produces different stimuli in several ways to replicate the physical world. The experience is almost indistinguishable to that provided by natural stimuli and affects all 5 senses.
“With regards to pharmacy, VR can potentially be applied as follows: added to or as a replacement for some drug therapies; in patient counseling and behavior modification; in drug design and discovery; and in pharmacist education,” Youssef said.
“There is still ongoing research with VR systems in these fields.” In a 2019 study2 published in Pharmacy and Therapeutics, investigators explored many of these applications.
“The majority of studies conducted during the past decade have found VR to be safe and e.ective, and to promote a high degree of user satisfaction,” the authors wrote, adding that “VR technology has become increasingly affordable, flexible, and portable, enabling its use for therapeutic purposes in both inpatient and outpatient environments.”
Ani Rostomyan, PharmD, has been practicing as a clinical pharmacist in Los Angeles for 7 years. An avid user of and educator about VR, she recently founded SheAni, Inc, a concierge consulting company that teaches patients and health care practitioners about drug metabolism, drug mechanisms of action, and pharmacogenomics utilizing VR.
She explained how VR provides a multisensorial experience, which enhances therapy and elicits true emotional and physiological responses that are nearly identical to the responses in real-life situations.
“As VR has advanced in pharmacy, I have noticed the storytelling format playing a bigger role,” Rostomyan said. “By making these complex and highly intricate biochemical processes more accessible and easier to understand, it helps patients get a better grasp of the information [that is] given to them, creating a much better environment for patient medication [adherence], disease state understanding, and patient outcomes.”
Kimberly Garza, PharmD, PhD, MBA, an associate professor and graduate program o.cer at Auburn University Harrison School of Pharmacy in Alabama, has been working with VR for some time.
“I first came to VR in the context of entertainment. It’s such a powerful experience and embodies the avatar that you are taking a perspective of, and it can really change people’s perception,” she said. “Once I started looking into how VR was being used in health care, I wanted to…learn how it could help with treatments.”
Using Auburn University’s dedicated VR space in their Innovation & Research Commons facility, Garza discovered how she could help patients with rheumatoid arthritis, utilizing VR to show them what disease progression would look like across differing treatment options.
Her pharmacy students are combining VR and haptic devices—mechanical devices that mediate communication between a user and computer—to learn about various physical limitations that patients may experience. Garza noted that the empathy-building learning activities are critical to the successful development of professional identity among her pharmacy students.
“Virtual reality creates a feeling of actually being there, a feeling that events are actually happening and… that you are actually inhabiting the virtual body,” Garza said.
The availability of VR systems in pharmacies can promote medication adherence and medication therapy management, as well as facilitate the development of a therapeutic action plan, according to Youssef.
“This can be done by providing short visual and auditory instructions regarding [the] medication and demonstrating techniques or administration practices,” she said. “Patients could then use the system to perform these behaviors virtually, allowing them to practice without harming themselves or wasting medication. Most patients are too shy or too anxious in the pharmacy to ask for advice or help, therefore with the introduction of self-serve VR, patients can step to the side and immerse themselves at ease.”
Study findings have also shown that a combination of VR and medical pain management can reduce severe pain experienced by people receiving wound care for burn injuries. VR helps control pain as it captures the mind’s attention and blocks pain signals from reaching the brain. It is akin to active hypnosis as it provides tactile and sensory feedback and enables the rallying of the neurotransmitter mechanisms that decrease pain. It can also be used to make injections and other painful or potentially frightening procedures less distressing to children.
VR has also proved effective for acute or chronic pain caused by injuries, and by cancer, neuropathy, migraine headaches, fibromyalgia, and pruritus, among other conditions.
“Perhaps the most highlighted implication regarding its efficacy is its potential to reduce the use of opioids, presenting a beacon of light in the current opioid crisis,” Youssef said. VR has also been studied as a treatment for anxiety and other mental health disorders.
“The current drug remedies available for such disease states work to influence physiological systems, easing the mind,” Youssef said, “whereas VR treats cognitive systems, immersing all senses in real-time use. This may be used to target treatment options not addressed by current drug models.”
Findings from another study on VR,3 whose results were published in JMIR Mental Health in 2017, described how patients who used VR programs were able to dramatically decrease pain scores without any adverse effects or abnormal vital signs.
“VR is not meant to be a sole treatment or modality for pain management,” Rostomyan said. “However, VR amplifies the effectiveness of other traditional approaches such as medications, physical therapy, and exercise.”
In a landmark decision, the FDA recently approved the first VR system for chronic lower back pain,4 providing an opioid-free alternative to many current pain management regimens. AppliedVR is behind the EaseVRx device, which utilizes cognitive behavioral therapy and other therapeutic techniques to guide patients through games, lessons, and exercises to reduce their chronic back pain. The immersive software experience comes about through a VR headset.
Patients are required to use the device for 2 to 16 minutes every day for 8 weeks. Through this treatment, the VR therapeutic offerings stand in for traditional treatment options.
“We worked tirelessly over the past few years to build an unmatched body of clinical evidence that demonstrates the power of VR for the treatment of pain and couldn’t be more thrilled to achieve this important milestone,”Josh Sackman, cofounder and president of AppliedVR, said in a company statement.5
“But our mission does not stop with this one approval. We’re committed to continuing research that validates our efficacy and cost-effectiveness for treating chronic pain and other indications.”
Most pharmacists advocating for VR believe it o.ers several advantages due to its creating an artificial environment so similar to the real world. “This implementation can even [be applied in] the educational sector to better understand drug binding and efficacy in the body with future pharmacokinetic use,” Youssef said.
“The enveloping effect of the virtual world has significant potential. With further research, more data will become available regarding its efficacy, and as the technology improves, costs and other obstacles will be reduced. Having another world in the pharmacy may begin to bridge the dissonance we see with patients and medication.”