Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis
BackgroundPrior studies have shown that virtual reality (VR) is an efficacious treatment modality for opioid-sparing pain management. However, the majority of these studies were conducted among primarily White, relatively advantaged populations and in well-resourced settings....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-09-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2021/9/e26623 |
| _version_ | 1797735703668326400 |
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| author | Urmimala Sarkar Jane E Lee Kim H Nguyen Sarah Lisker Courtney R Lyles |
| author_facet | Urmimala Sarkar Jane E Lee Kim H Nguyen Sarah Lisker Courtney R Lyles |
| author_sort | Urmimala Sarkar |
| collection | DOAJ |
| description |
BackgroundPrior studies have shown that virtual reality (VR) is an efficacious treatment modality for opioid-sparing pain management. However, the majority of these studies were conducted among primarily White, relatively advantaged populations and in well-resourced settings.
ObjectiveWe conducted a qualitative, theory-informed implementation science study to assess the readiness for VR in safety-net settings.
MethodsUsing the theoretical lens of the Consolidated Framework for Implementation Research (CFIR) framework, we conducted semistructured interviews with current VR users and nonusers based in safety-net health systems (n=15). We investigated barriers and facilitators to a commercially available, previously validated VR technology platform AppliedVR (Los Angeles, CA, USA). We used deductive qualitative analysis using the overarching domains of the CFIR framework and performed open, inductive coding to identify specific themes within each domain.
ResultsInterviewees deemed the VR intervention to be useful, scalable, and an appealing alternative to existing pain management approaches. Both users and nonusers identified a lack of reimbursement for VR as a significant challenge for adoption. Current users cited positive patient feedback, but safety-net stakeholders voiced concern that existing VR content may not be relevant or appealing to diverse patients. All respondents acknowledged the challenge of integrating and maintaining VR in current pain management workflows across a range of clinical settings, and this adoption challenge was particularly acute, given resource and staffing constraints in safety-net settings.
ConclusionsVR for pain management holds interest for frontline pain management clinicians and leadership in safety-net health settings but will require significant tailoring and adaption to address the needs of diverse populations. Integration into complex workflows for pain management is a significant barrier to adoption, and participants cited structural cost and reimbursement concerns as impediments to initial implementation and scaling of VR use. |
| first_indexed | 2024-03-12T13:02:42Z |
| format | Article |
| id | doaj.art-e7b4fa029e1544729ff325450b9cba33 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T13:02:42Z |
| publishDate | 2021-09-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-e7b4fa029e1544729ff325450b9cba332023-08-28T19:07:40ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-09-01239e2662310.2196/26623Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative AnalysisUrmimala Sarkarhttps://orcid.org/0000-0003-4213-4405Jane E Leehttps://orcid.org/0000-0002-4985-3245Kim H Nguyenhttps://orcid.org/0000-0002-9112-0221Sarah Liskerhttps://orcid.org/0000-0002-0194-0235Courtney R Lyleshttps://orcid.org/0000-0002-1111-8595 BackgroundPrior studies have shown that virtual reality (VR) is an efficacious treatment modality for opioid-sparing pain management. However, the majority of these studies were conducted among primarily White, relatively advantaged populations and in well-resourced settings. ObjectiveWe conducted a qualitative, theory-informed implementation science study to assess the readiness for VR in safety-net settings. MethodsUsing the theoretical lens of the Consolidated Framework for Implementation Research (CFIR) framework, we conducted semistructured interviews with current VR users and nonusers based in safety-net health systems (n=15). We investigated barriers and facilitators to a commercially available, previously validated VR technology platform AppliedVR (Los Angeles, CA, USA). We used deductive qualitative analysis using the overarching domains of the CFIR framework and performed open, inductive coding to identify specific themes within each domain. ResultsInterviewees deemed the VR intervention to be useful, scalable, and an appealing alternative to existing pain management approaches. Both users and nonusers identified a lack of reimbursement for VR as a significant challenge for adoption. Current users cited positive patient feedback, but safety-net stakeholders voiced concern that existing VR content may not be relevant or appealing to diverse patients. All respondents acknowledged the challenge of integrating and maintaining VR in current pain management workflows across a range of clinical settings, and this adoption challenge was particularly acute, given resource and staffing constraints in safety-net settings. ConclusionsVR for pain management holds interest for frontline pain management clinicians and leadership in safety-net health settings but will require significant tailoring and adaption to address the needs of diverse populations. Integration into complex workflows for pain management is a significant barrier to adoption, and participants cited structural cost and reimbursement concerns as impediments to initial implementation and scaling of VR use.https://www.jmir.org/2021/9/e26623 |
| spellingShingle | Urmimala Sarkar Jane E Lee Kim H Nguyen Sarah Lisker Courtney R Lyles Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis Journal of Medical Internet Research |
| title | Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis |
| title_full | Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis |
| title_fullStr | Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis |
| title_full_unstemmed | Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis |
| title_short | Barriers and Facilitators to the Implementation of Virtual Reality as a Pain Management Modality in Academic, Community, and Safety-Net Settings: Qualitative Analysis |
| title_sort | barriers and facilitators to the implementation of virtual reality as a pain management modality in academic community and safety net settings qualitative analysis |
| url | https://www.jmir.org/2021/9/e26623 |
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