Virtual Reality Devices as an Adjunct to Usual Care for Patients With Sickle Cell Disease Experiencing Vaso-Occlusive Crises

NCT ID: NCT06184126

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-01

Study Completion Date

2026-12-31

Brief Summary

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This study aims to evaluate the use of virtual reality as an adjunct to standard care for patients with sickle cell disease experiencing vaso-occlusive crises.

Detailed Description

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A prospective, non-blinded, non-randomized trial will be conducted at the Adult Emergency Department at the University of Maryland Medical Center and Adult Urgent Care Center, which is managed by the Department of Emergency Medicine, located in Baltimore, Maryland.

Patients meeting eligibility criteria and who have signed the research informed consent will be enrolled in this study. Subject data collected will include demographic information, symptoms of the current illness and physical exam findings.

Upon enrollment into the study, a study team member will interview the patient to collect data needed to complete the Case Report Form. Patients assigned to one of the two virtual reality study groups will be directed by research coordinators who can help with equipment as needed throughout the session. The virtual reality device will be limited to a maximum of 2 hours of use. Assessments will be made at 4 different timepoints: 1) Immediately before the intervention, 2) at the 1-hour mark of the intervention, 3) immediately after the intervention, and 4) 1 hour after the intervention. During these assessments, patients will rate their pain intensity using a 0-10 numerical scale. Additionally, at each assessment, patients will be asked to state the change in pain that has taken place since the last measurement. This measurement will be performed without informing the patient of their previously recorded pain scores.

Data will also be recorded regarding the patient's 1) comfort of the device, 2) disposition (discharged home vs observation/admission status), 3) total length of treatment time in the ED (measured as time to initiation of any treatment to the time of final disposition), and 4) total amount of opioids administered while under the care of the emergency department clinicians, converted into morphine milligram equivalents. Each patient will complete a questionnaire at the conclusion of the session regarding their perceived impact of the intervention, ease of use, and likelihood to reuse the intervention.

Conditions

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Sickle Cell Disease Vaso-occlusive Pain Episode in Sickle Cell Disease Acute Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a prospective, non-blinded, randomized clinical control trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Once the participant has been enrolled in the study, they will be randomized to either the control arm or one of the experimental arms. No masking is being performed. Once randomization has occurred, participants, care providers, and the investigators will know which group the participants are in.

Study Groups

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Active Immersive Virtual Reality

Patient with sickle cell disease experiencing acute vaso-occlusive crisis randomized to this arm will participate in an active immersive application on the virtual reality headset with hand-held controllers. The active immersive application will allow the user to interact directly with the application and move through the virtual environment .The patient will be able to use the active immersive application on the device for a maximum of two hours.

Group Type EXPERIMENTAL

Virtual Reality Headset and Hand-Held Controllers

Intervention Type DEVICE

Study Group-Virtual reality headset and hand-held controllers will be used as an adjuvant to pain management care.

Passive Immersive Virtual Reality

Patient with sickle cell disease experiencing acute vaso-occlusive crisis randomized to this arm will participate in a passive immersive application on the virtual reality headset with hand-held controllers. The passive immersive application will not allow the user to interact directly with the application or move through the virtual environment .The patient will be able to use the passive immersive application on the device for a maximum of two hours.

Group Type EXPERIMENTAL

Virtual Reality Headset and Hand-Held Controllers

Intervention Type DEVICE

Study Group-Virtual reality headset and hand-held controllers will be used as an adjuvant to pain management care.

Blindfold and Ear Plugs

Patient with sickle cell disease experiencing acute vaso-occlusive crisis randomized to this arm will wear a blindfold and ear plugs. The patient will be able to remain blindfolded and earplugs for a maximum of two hours.

Group Type PLACEBO_COMPARATOR

Blindfolding and Noise Cancelling

Intervention Type OTHER

Control group-Blindfold and noise cancelling headphones will be a placebo comparator group to the experimental interventions of virtual reality devices.

Interventions

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Virtual Reality Headset and Hand-Held Controllers

Study Group-Virtual reality headset and hand-held controllers will be used as an adjuvant to pain management care.

Intervention Type DEVICE

Blindfolding and Noise Cancelling

Control group-Blindfold and noise cancelling headphones will be a placebo comparator group to the experimental interventions of virtual reality devices.

Intervention Type OTHER

Other Intervention Names

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Meta Quest 2

Eligibility Criteria

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Inclusion Criteria

* Adult (age \> 18 years) emergency department patient
* History of sickle cell disease
* Presenting to the emergency department due to acute pain related to sickle cell disease thought to be due to vaso-occlusive crisis

Exclusion Criteria

* Prior enrollment in this study
* Presenting with a chief complaint suggestive of a complicated crisis (such as concern for acute chest syndrome, splenic sequestration, hepatic sequestration, pulmonary embolism) as determined by the clinical care provider
* Not being treated with intravenous opioids for the vaso-occlusive crisis
* Patients who lack the capacity to provide informed consent
* Medical history of seizures or known intolerance to virtual reality
* Disabilities like vision and hearing defects etc. that preclude the use of a head mounted virtual reality device.
* Known to be pregnant
* Incarcerated at the time of evaluation
* Over the age of 89 years old
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Maryland, Baltimore

OTHER

Sponsor Role lead

Responsible Party

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Richard Gentry Wilkerson

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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R. Gentry Wilklerson, MD

Role: PRINCIPAL_INVESTIGATOR

U of Maryland, Baltimore

Locations

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University of Maryland Medical Systems

Baltimore, Maryland, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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R. Gentry Wilkerson, MD

Role: CONTACT

Phone: 410-328-4237

Email: [email protected]

Facility Contacts

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R. Gentry Wilkerson, MD

Role: primary

References

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Sundd P, Gladwin MT, Novelli EM. Pathophysiology of Sickle Cell Disease. Annu Rev Pathol. 2019 Jan 24;14:263-292. doi: 10.1146/annurev-pathmechdis-012418-012838. Epub 2018 Oct 17.

Reference Type BACKGROUND
PMID: 30332562 (View on PubMed)

Jang T, Poplawska M, Cimpeanu E, Mo G, Dutta D, Lim SH. Vaso-occlusive crisis in sickle cell disease: a vicious cycle of secondary events. J Transl Med. 2021 Sep 20;19(1):397. doi: 10.1186/s12967-021-03074-z.

Reference Type BACKGROUND
PMID: 34544432 (View on PubMed)

Duroseau Y, Beenhouwer D, Broder MS, Brown B, Brown T, Gibbs SN, Jackson K, Liang S, Malloy M, Romney ML, Shani D, Simon J, Yermilov I. Developing an emergency department order set to treat acute pain in sickle cell disease. J Am Coll Emerg Physicians Open. 2021 Aug 7;2(4):e12487. doi: 10.1002/emp2.12487. eCollection 2021 Aug.

Reference Type BACKGROUND
PMID: 34401866 (View on PubMed)

Osunkwo I, Manwani D, Kanter J. Current and novel therapies for the prevention of vaso-occlusive crisis in sickle cell disease. Ther Adv Hematol. 2020 Sep 29;11:2040620720955000. doi: 10.1177/2040620720955000. eCollection 2020.

Reference Type BACKGROUND
PMID: 33062233 (View on PubMed)

Williams H, Tanabe P. Sickle Cell Disease: A Review of Nonpharmacological Approaches for Pain. J Pain Symptom Manage. 2016 Feb;51(2):163-77. doi: 10.1016/j.jpainsymman.2015.10.017. Epub 2015 Nov 17.

Reference Type BACKGROUND
PMID: 26596876 (View on PubMed)

Chuan A, Zhou JJ, Hou RM, Stevens CJ, Bogdanovych A. Virtual reality for acute and chronic pain management in adult patients: a narrative review. Anaesthesia. 2021 May;76(5):695-704. doi: 10.1111/anae.15202. Epub 2020 Jul 27.

Reference Type BACKGROUND
PMID: 32720308 (View on PubMed)

Smith V, Warty RR, Sursas JA, Payne O, Nair A, Krishnan S, da Silva Costa F, Wallace EM, Vollenhoven B. The Effectiveness of Virtual Reality in Managing Acute Pain and Anxiety for Medical Inpatients: Systematic Review. J Med Internet Res. 2020 Nov 2;22(11):e17980. doi: 10.2196/17980.

Reference Type BACKGROUND
PMID: 33136055 (View on PubMed)

Agrawal AK, Robertson S, Litwin L, Tringale E, Treadwell M, Hoppe C, Marsh A. Virtual reality as complementary pain therapy in hospitalized patients with sickle cell disease. Pediatr Blood Cancer. 2019 Feb;66(2):e27525. doi: 10.1002/pbc.27525. Epub 2018 Oct 26.

Reference Type BACKGROUND
PMID: 30362236 (View on PubMed)

Mercado SH. An outpatient pain plan and ED pain pathway for adults with sickle cell disease. JAAPA. 2023 Mar 1;36(3):20-23. doi: 10.1097/01.JAA.0000920956.33631.26.

Reference Type BACKGROUND
PMID: 36752670 (View on PubMed)

Other Identifiers

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HP-00106992

Identifier Type: -

Identifier Source: org_study_id