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Tagliaferri L, Fionda B, Casà C, Cornacchione P, Scalise S, Chiesa S, Marconi E, Dinapoli L, Di Capua B, Chieffo DPR, Marazzi F, Frascino V, Colloca GF, Valentini V, Miccichè F, Gambacorta MA. Allies not enemies-creating a more empathetic and uplifting patient experience through technology and art. Strahlenther Onkol 2024:10.1007/s00066-024-02279-7. [PMID: 39259348 DOI: 10.1007/s00066-024-02279-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 07/07/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE To understand whether art and technology (mainly conversational agents) may help oncology patients to experience a more humanized journey. METHODS This narrative review encompasses a comprehensive examination of the existing literature in this field by a multicenter, multidisciplinary, and multiprofessional team aiming to analyze the current developments and potential future directions of using art and technology for patient engagement. RESULTS We identified three major themes of patient engagement with art and three major themes of patient engagement with technologies. Two real-case scenarios are reported from our experience to practically envision how findings from the literature can be implemented in different contexts. CONCLUSION Art therapy and technologies can be ancillary supports for healthcare professionals but are not substitutive of their expertise and responsibilities. Such tools may help to convey a more empathetic and uplifting patient journey if properly integrated within clinical practice, whereby the humanistic touch of medicine remains pivotal.
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Affiliation(s)
- Luca Tagliaferri
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bruno Fionda
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Calogero Casà
- UOC di Radioterapia Oncologica, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy.
- Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Patrizia Cornacchione
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Sara Scalise
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Elisa Marconi
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Loredana Dinapoli
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Beatrice Di Capua
- Centro di Eccellenza Oncologia Radioterapica e Medica e Radiologia, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS di Psicologia Clinica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabio Marazzi
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Vincenzo Frascino
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Giuseppe Ferdinando Colloca
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Vincenzo Valentini
- Centro di Eccellenza Oncologia Radioterapica e Medica e Radiologia, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Francesco Miccichè
- UOC di Radioterapia Oncologica, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
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Cuñado-Pradales R, Soto-Ruiz N, Escalada-Hernández P, San Martín-Rodríguez L, García-Vivar C. Virtual Reality to Reduce Pain, Fatigue, and Emotional Distress in People With Cancer: A Scoping Review. Cancer Nurs 2024:00002820-990000000-00289. [PMID: 39221925 DOI: 10.1097/ncc.0000000000001401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Cancer and its treatments cause symptoms such as pain, fatigue, and emotional distress, which affect the quality of life of patients at different stages of cancer. Virtual reality (VR) has emerged as a promising alternative for addressing these symptoms by immersing patients in a virtual environment that isolates them from reality. OBJECTIVE To describe the existing evidence on the use of VR to improve pain, fatigue, and emotional distress in people with cancer at different stages of the cancer trajectory. METHODS A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Search was conducted in PubMed and CINAHL until October 2023. RESULTS Twenty-three primary studies related to the study topic were identified, and the following information was collected: type of VR (immersive vs nonimmersive) used in oncology services, purpose (distraction, training, or relaxation), devices used (head-mounted display, headset, or virtual controller), and the environment simulated (natural environment, skill games, or educational environment). The effects of VR on pain, fatigue, and emotional distress are described, highlighting its ability to mitigate these symptoms in the short term. CONCLUSIONS Virtual reality has been shown to be an effective technique for reducing pain, fatigue, and emotional distress in people with cancer in the short term. IMPLICATIONS FOR PRACTICE Nurses can use VR as a complementary tool to promote virtual environments that improve the care for and therefore the quality of life of people with cancer.
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Affiliation(s)
- Rebeca Cuñado-Pradales
- Author Affiliations: Santos Reyes Hospital, Castilla y León Regional Health Management, Aranda de Duero, Castilla y León (Ms Cuñado-Pradales); Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Navarra (Drs Soto-Ruiz, Escalada-Hernández, San Martín-Rodríguez, and García-Vivar); and IdiSNA, Navarra Institute for Health Research, Pamplona (Drs Soto-Ruiz, Escalada-Hernández, San Martín-Rodríguez, and García-Vivar), Spain
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Mitello L, Marti F, Mauro L, Siano L, Pucci A, Tarantino C, Rocco G, Stievano A, Iacorossi L, Anastasi G, Ferrara R, Marucci AR, Varrassi G, Giannarelli D, Latina R. The Usefulness of Virtual Reality in Symptom Management during Chemotherapy in Lung Cancer Patients: A Quasi-Experimental Study. J Clin Med 2024; 13:4374. [PMID: 39124641 PMCID: PMC11312944 DOI: 10.3390/jcm13154374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Virtual reality (VR) emerges as a promising non-pharmacological intervention for managing symptoms and providing distraction during chemotherapy. This study aims to assess VR's effectiveness on cancer-related symptoms, vital signs, and the patients' perception of chemotherapy in lung cancer patients. Methods: A quasi-experimental study was conducted on 100 patients. Participants were allocated into an intervention group (n = 55), which experienced immersive VR, and a comparison group (n = 45), which received usual care. Data were collected through questionnaires and checklists, including feedback on the VR experience, pain, vital signs, and common cancer symptoms, assessed through the Edmonton Symptom Assessment Scale. Results: VR had a significant impact on reducing the perception of chemotherapy length. Patients reported high levels of satisfaction and tolerability. No adverse events were observed. VR did not have significant influence on pain intensity or vital signs. The only exceptions were oxygen saturation, where a significant difference (p = 0.02) was reported, and the perception of chemotherapy duration. Conclusions: As a non-pharmacological intervention, VR proves to be beneficial in minimizing the perceived length of chemotherapy sessions for lung cancer patients, enhancing their overall treatment experience. The intervention was found to be a safe, feasible, and well-accepted distraction technique. Future research should explore VR's potential effects on a wider range of symptoms and evaluate its impact on long-term outcomes.
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Affiliation(s)
- Lucia Mitello
- Department of Health Professions, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.M.); (L.M.); (A.P.); (C.T.); (A.R.M.)
| | - Flavio Marti
- Department of Health Professions, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.M.); (L.M.); (A.P.); (C.T.); (A.R.M.)
- School of Nursing and Midwifery, Faculty of Medicine and Psychology, Sapienza University of Rome, 00152 Rome, Italy
| | - Lucia Mauro
- Department of Health Professions, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.M.); (L.M.); (A.P.); (C.T.); (A.R.M.)
| | - Ludovica Siano
- Emergency Department, Fatebenefratelli Hospital, 00189 Rome, Italy;
| | - Antonello Pucci
- Department of Health Professions, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.M.); (L.M.); (A.P.); (C.T.); (A.R.M.)
| | - Concetta Tarantino
- Department of Health Professions, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.M.); (L.M.); (A.P.); (C.T.); (A.R.M.)
| | - Gennaro Rocco
- Center of Excellence for Nursing Scholarship, OPI of Rome, 00136 Rome, Italy;
- Faculty of Medicine, Catholic University Our Lady of Good Counsel, 1005 Tirana, Albania
| | - Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Laura Iacorossi
- Department of Life, Health and Health Professions Sciences Link Campus University, 00165 Rome, Italy;
| | - Giuliano Anastasi
- Department of Trauma, AOU G. Martino University Hospital, 98124 Messina, Italy;
| | - Rosaria Ferrara
- Department of Anatomy Histology, Legal Medicine and Orthopaedics, Sapienza University of Rome, 00161 Rome, Italy;
| | - Anna Rita Marucci
- Department of Health Professions, San Camillo-Forlanini Hospital, 00152 Rome, Italy; (L.M.); (L.M.); (A.P.); (C.T.); (A.R.M.)
| | | | - Diana Giannarelli
- Facility of Epidemiology and Biostatistics, IRCCS Policlinico Gemelli, 00168 Rome, Italy;
| | - Roberto Latina
- Department of Health Promotion Science, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy;
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Biskupiak Z, Ha VV, Rohaj A, Bulaj G. Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases. J Clin Med 2024; 13:403. [PMID: 38256537 PMCID: PMC10816409 DOI: 10.3390/jcm13020403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Limitations of pharmaceutical drugs and biologics for chronic diseases (e.g., medication non-adherence, adverse effects, toxicity, or inadequate efficacy) can be mitigated by mobile medical apps, known as digital therapeutics (DTx). Authorization of adjunct DTx by the US Food and Drug Administration and draft guidelines on "prescription drug use-related software" illustrate opportunities to create drug + digital combination therapies, ultimately leading towards drug-device combination products (DTx has a status of medical devices). Digital interventions (mobile, web-based, virtual reality, and video game applications) demonstrate clinically meaningful benefits for people living with Alzheimer's disease, dementia, rheumatoid arthritis, cancer, chronic pain, epilepsy, depression, and anxiety. In the respective animal disease models, preclinical studies on environmental enrichment and other non-pharmacological modalities (physical activity, social interactions, learning, and music) as surrogates for DTx "active ingredients" also show improved outcomes. In this narrative review, we discuss how drug + digital combination therapies can impact translational research, drug discovery and development, generic drug repurposing, and gene therapies. Market-driven incentives to create drug-device combination products are illustrated by Humira® (adalimumab) facing a "patent-cliff" competition with cheaper and more effective biosimilars seamlessly integrated with DTx. In conclusion, pharma and biotech companies, patients, and healthcare professionals will benefit from accelerating integration of digital interventions with pharmacotherapies.
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Affiliation(s)
- Zack Biskupiak
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Victor Vinh Ha
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Aarushi Rohaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
- The Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84113, USA
| | - Grzegorz Bulaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
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Alhusamiah B, Aldiqs M, Zeilani RS. The Effectiveness of Immersive Virtual Reality as A Complementary Approach and a New Direction in Cancer Related Fatigue Management. Integr Cancer Ther 2024; 23:15347354241280272. [PMID: 39305200 PMCID: PMC11421400 DOI: 10.1177/15347354241280272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024] Open
Abstract
Background: Recent advancements in the field of medical technology have illuminated that the implementation of virtual reality interventions can be highly effective in managing cancer-related fatigue. Moreover, this innovative intervention has demonstrated a substantial improvement in patients' overall well-being and daily functioning. Thus, it represents a promising alternative to traditional pharmacological treatments by effectively addressing symptoms and enhancing quality of life. Therefore, the integration of this approach signifies a significant advancement in patient care. Nevertheless, despite the ongoing efforts to diversify non-pharmacological treatments, pharmacological interventions are still the predominant method for managing cancer-related fatigue. Aim: This systematic review aimed to evaluate the effectiveness of immersive virtual reality in cancer-related fatigue management, and to explore the main side effects of immersive virtual reality. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Several online databases were used to find eligible studies in peer-reviewed journals relevant to the study keywords. Specifically, the included studies were systematic reviews and clinical trials that used immersive virtual reality-based intervention among adult patients with cancer and suffering from cancer-related fatigue. As well as were published in the English language from 2014 to 2024. As well as, three researchers independently contributed to study selections, data extraction, and study evaluations from different aspects: including quality assessment, risk of bias, and study synthesis. Results: After an extensive and comprehensive search, a total of ten published studies were included in this review study; 6 articles were quantitative clinical trial studies, and the other 4 were systematic review and meta-analysis studies. The quality of 6 included clinical trials was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for quantitative studies, the overall result showed that 33.3% of studies rated with moderate quality, no study was rated with low quality, and (66.7%) studies rated as high-quality studies. As well, the quality assessment of all review studies showed that all included systematic reviews and meta-analyses with a low risk of bias and high to moderate power of evidence. The result of this extensive and comprehensive review showed that immersive virtual reality has a significant effect in reducing cancer-related fatigue, however, still, there is a significant variation in the employment of immersive Virtual Reality protocols for cancer symptom management worldwide. Conclusion: Immersive virtual reality is an effective non-pharmacological intervention in reducing and controlling cancer-related fatigue among patients with various types of cancer, as well as being an affordable, cost-effective approach. Nevertheless, there remains a notable gap in the existing literature concerning virtual reality protocols, associated side effects, and the underlying mechanisms by which immersive virtual reality alleviates fatigue. Therefore, further research studies are warranted to address these gaps and advance our understanding in these areas.
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Affiliation(s)
| | - Mohannad Aldiqs
- Al-Ahliyya Amman University, Faculty of Nursing, Amman, Jordan
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