Efficacy of Virtual Reality in Managing Pain for Patients in Palliative Care: A Systematic Review and Meta-Analysis.

Abstract

Pain management in palliative care, especially among cancer patients, remains a critical challenge that significantly affects patient quality of life. Virtual Reality (VR) has emerged as a promising nonpharmacological intervention that could revolutionize pain management strategies in this vulnerable population. This systematic review and meta-analysis evaluate the effectiveness of VR interventions, focusing exclusively on randomized controlled trials to provide a comprehensive assessment of VR as a therapeutic tool. This systematic review and meta-analysis followed the JBI methodology for randomized controlled trials (RCTs). English-language RCTs evaluating VR for pain management in adult palliative care cancer patients were included. Due to COVID-19-related publication delays, the search extended beyond the standard five-year scope. Keywords used included "virtual reality," "pain management," "palliative care," and "cancer patients," across databases such as PubMed, Scopus, Web of Science, and PsycINFO. Exclusions covered nonrandomized studies and those with methodological flaws. Study selection was conducted using Covidence. Data analysis was performed using STATA V. 17, calculating standardized mean differences (SMDs) for pain measurement scales. The analysis of ten trials demonstrated VR's capability to significantly reduce pain intensity in palliative care. The pooled effect size showed a moderate to large reduction in pain, with enhanced effectiveness observed in longer VR sessions and with interactive content. Despite variability, the consistent findings support VR's potential as a flexible and adaptable approach to pain management. Virtual reality offers a promising alternative for pain management in palliative care, highlighting the necessity for standardized protocols and further research into its long-term effects and economic viability. To gain a deeper understanding of how VR affects patient experiences and outcomes, future research should implement mixed-methods studies that combine quantitative data with qualitative insights. This approach will allow for a more comprehensive evaluation of VR's impact on the quality of life and pain management strategies, ensuring that interventions are tailored to meet the complex needs of palliative care patients. The current study registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number [CRD42024512961].