Estimating the Economic Value of Automated Virtual Reality Cognitive Therapy for Treating Agoraphobic Avoidance in Patients With Psychosis: Findings From the gameChange Randomized Controlled Clinical Trial

Altunkaya, James; Craven, Michael P.; Lambe, Sinéad; Petit, Ariane; Rosebrock, Laina; Dudley, Robert; Chapman, Kate; Morrison, Anthony P.; O’Regan, Eileen; Grabey, Jenna; Bergin, Aislinn; Kabir, Thomas; Freeman, Daniel; Leal, José

doi:10.2196/39248

Cited by 12 publications

(3 citation statements)

References 24 publications

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“…The interviews provided fascinating in-depth insights into the experience with automated VR therapy, which will inform the delivery of gameChange alongside other implementation and health economic studies [23][24][25]. This study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

A Safe Place to Learn: Peer Research Qualitative Investigation of gameChange Virtual Reality Therapy

Bond,

Kenny,

Pinfold

et al. 2023

JMIR Serious Games

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Background Automated virtual reality (VR) therapy has the potential to substantially increase access to evidence-based psychological treatments. The results of a multicenter randomized controlled trial showed that gameChange VR cognitive therapy reduces the agoraphobic avoidance of people diagnosed with psychosis, especially for those with severe avoidance. Objective We set out to use a peer research approach to explore participants’ experiences with gameChange VR therapy. This in-depth experiential exploration of user experience may inform the implementation in clinical services and future VR therapy development. Methods Peer-led semistructured remote interviews were conducted with 20 people with a diagnosis of psychosis who had received gameChange as part of the clinical trial (ISRCTN17308399). Data were analyzed using interpretative phenomenological analysis and template analyses. A multiperspectival approach was taken to explore subgroups. Credibility checks were conducted with the study Lived Experience Advisory Panel. Results Participants reported the substantial impact of anxious avoidance on their lives before the VR intervention, leaving some of them housebound and isolated. Those who were struggling the most with agoraphobic avoidance expressed the most appreciation for, and gains from, the gameChange therapy. The VR scenarios provided “a place to practise.” Immersion within the VR scenarios triggered anxiety, yet participants were able to observe this and respond in different ways than usual. The “security of knowing the VR scenarios are not real” created a safe place to learn about fears. The “balance of safety and anxiety” could be calibrated to the individual. The new learning made in VR was “taken into the real world” through practice and distilling key messages with support from the delivery staff member. Conclusions Automated VR can provide a therapeutic simulation that allows people diagnosed with psychosis to learn and embed new ways of responding to the situations that challenge them. An important process in anxiety reduction is enabling the presentation of stimuli that induce the original anxious fears yet allow for learning of safety. In gameChange, the interaction of anxiety and safety could be calibrated to provide a safe place to learn about fears and build confidence. This navigation of therapeutic learning can be successfully managed by patients themselves in an automated therapy, with staff support, that provides users with personalized control. The clinical improvements for people with severe anxious avoidance, the positive experience of VR, and the maintenance of a sense of control are likely to facilitate implementation.

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Section: Discussionmentioning

confidence: 99%

A Safe Place to Learn: Peer Research Qualitative Investigation of gameChange Virtual Reality Therapy

Bond,

Kenny,

Pinfold

et al. 2023

JMIR Serious Games

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“…Not only apps measuring fatigue through questionnaires but also wearable devices have proved to be useful in the continuous monitoring of fatigued MS patients (Sparaco et al, 2018;Tong et al, 2019;Block et al, 2022). These "health technologies" usually have an internet or smartphone connection and therefore allow non-stop collection of data about physiological parameters (e.g., heart rate, sleep levels) and track any kind 2019;Maggio et al, 2019a,b;Cuesta-Gómez et al, 2020;Manuli et al, 2020;Ozkul et al, 2020;Yazgan et al, 2020;Cortés-Pérez et al, 2021;Leonardi et al, 2021;Nascimento et al, 2021;Pagliari et al, 2021;Altunkaya et al, 2022;Casuso-Holgado et al, 2022;Hollywood et al, 2022;Kalron et al, 2022;Moeinzadeh et al, 2022;Dogan et al, 2023;Hsu et al, 2023) Computer of physical activities through accelerometers and sensors (Sparaco et al, 2018).…”

Section: Wearable Devicesmentioning

confidence: 99%

Fatigue: Physiology and Pathology

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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“…Not only apps measuring fatigue through questionnaires but also wearable devices have proved to be useful in the continuous monitoring of fatigued MS patients (Sparaco et al, 2018;Tong et al, 2019;Block et al, 2022). These "health technologies" usually have an internet or smartphone connection and therefore allow non-stop collection of data about physiological parameters (e.g., heart rate, sleep levels) and track any kind Manuli et al, 2020;Ozkul et al, 2020;Yazgan et al, 2020;Cortés-Pérez et al, 2021;Leonardi et al, 2021;Nascimento et al, 2021;Pagliari et al, 2021;Altunkaya et al, 2022;Casuso-Holgado et al, 2022;Hollywood et al, 2022;Kalron et al, 2022;Moeinzadeh et al, 2022;Dogan et al, 2023;Hsu et al, 2023) Computer of physical activities through accelerometers and sensors (Sparaco et al, 2018).…”

Section: Wearable Devicesmentioning

confidence: 99%

Management of multiple sclerosis fatigue in the digital age: from assessment to treatment

Pinarello,

Elmers,

Inojosa

et al. 2023

Front. Neurosci.

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Fatigue is one of the most disabling symptoms of Multiple Sclerosis (MS), affecting more than 80% of patients over the disease course. Nevertheless, it has a multi-faceted and complex nature, making its diagnosis, evaluation, and treatment extremely challenging in clinical practice. In the last years, digital supporting tools have emerged to support the care of people with MS. These include not only smartphone or table-based apps, but also wearable devices or novel techniques such as virtual reality. Furthermore, an additional effective and cost-efficient tool for the therapeutic management of people with fatigue is becoming increasingly available. Virtual reality and e-Health are viable and modern tools to both assess and treat fatigue, with a variety of applications and adaptability to patient needs and disability levels. Most importantly, they can be employed in the patient's home setting and can not only bridge clinic visits but also be complementary to the monitoring and treatment means for those MS patients who live far away from healthcare structures. In this narrative review, we discuss the current knowledge and future perspectives in the digital management of fatigue in MS. These may also serve as sources for research of novel digital biomarkers in the identification of disease activity and progression.

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Estimating the Economic Value of Automated Virtual Reality Cognitive Therapy for Treating Agoraphobic Avoidance in Patients With Psychosis: Findings From the gameChange Randomized Controlled Clinical Trial

Cited by 12 publications

References 24 publications

A Safe Place to Learn: Peer Research Qualitative Investigation of gameChange Virtual Reality Therapy

A Safe Place to Learn: Peer Research Qualitative Investigation of gameChange Virtual Reality Therapy

Fatigue: Physiology and Pathology

Management of multiple sclerosis fatigue in the digital age: from assessment to treatment

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