Developing and refining a virtual reality intervention that will help to manage pain for people living with advanced cancer

Research questions RQ1: What does a co-designed virtual reality intervention to help people living with advanced cancer manage their pain look like? RQ2: What should a co-designed manual for a virtual reality intervention contain? RQ3: How would a virtual reality intervention for pain management in advanced cancer work in practice?

Background Pain is commonly experienced by people who are living with advanced (incurable) cancer.

There is evidence to suggest virtual reality could help to relieve this pain: however, this evidence is poor quality with the intervention poorly defined.

A robustly co-designed intervention, with people who have advanced cancer and experience pain, will facilitate a better evidence-base.

Aim To develop and refine a virtual reality intervention that will help people living with advanced cancer to manage pain.

Objectives Explore and establish key components of a virtual reality intervention for people with advanced cancer in terms of effectiveness, acceptability and feasibility using in-depth interviews and focus groups with people living with advanced cancer and experiencing different types of pain. Develop and manualise a virtual reality intervention using co-design methodology.

User-test the intervention to refine further.

Methods Multi-method design, incorporating multiple stakeholder perspectives, over three phases: Phase 1: Focus groups or individual interviews with a total of 40 people, from four locations (Brighton, Cardiff, Liverpool, & London), who have advanced cancer and experience pain.

They will use the virtual reality intervention and give feedback on what resonated with them and what they would change.

Phase 2: Four focus groups (one at each study location) with multiple stakeholders including: healthcare professionals, technology specialists, and people with lived experience.

During this stage, the findings from phase 1 will be presented and a manual will be produced that gives guidelines on use of the virtual reality intervention.

Phase 3: Up to 20 people living with advanced cancer and pain will user-test the intervention over an eight-week period.

During this phase, we will test if/how often the virtual reality is used as part of routine practice in each site and identify any barriers of use. Timelines for delivery 15-month project. Approvals: months -4 to 0; Phase 1: months 0-9; phase 2 months 9-2; phase 3 months 13-15. The intervention and manual development phase will run iteratively from month 7 onwards, as new data is collected.

Anticipated Impact and Dissemination 1.

A robustly co-designed intervention, ready for testing in a larger trial, to assess the clinical and cost effectiveness of virtual reality as a form of pain management. 2. Guidelines for the use of virtual reality in a clinical setting.

The results will be published through academic routes (peer-reviewed publications as well as presented at national and international conferences).

We will also work with our group of people with lived experience and an oversight committee to establish the best other routes to disseminate the findings to the public e.g., a social media campaign, leaflets to clinical settings, blog and vlog posts.