Improving medicines adherence with VR

With medicine adherence still a major problem for pharma and healthcare systems, a collaboration between Cognitant Group and Addenbrooke’s Hospital –supported by grants from UCB and Pfizer – is piloting a programme that aims to educate patients through the power of virtual reality (VR).

The programme provides health information in the form of “visual and immersive experiences”, and is initially being used for patients prescribed a biologic medicine to treat rheumatoid arthritis.

The immersive patient programme entails virtual consultations with a consultant rheumatologist and nurse. Patients will have access to an interactive explanation of the disease process, and the mode of action of the medicine used to treat it. It will also feature a 360-degree video of an injection demo, and a series of infographics and virtual objects to aid knowledge retention.

The main aims of the programme are to improve compliance with medication and ensure better outcomes for the patients by prescribing interactive health information.

UCB’s medical solutions lead Paul Atherford says that presenting complex health information in the form of VR is “more visual, engaging, clear and accessible”.

“Typical ways of communicating health information to patients, whether it be through leaflets, or explaining complex health issues during a brief appointment, are somewhat limited,” he adds.

“With VR, patients have access to crucial information at their fingertips, which will hopefully empower them with their disease management. This will help patients understand all aspects of their consultation, and in turn, better self-manage their disease.”

Deepak Jadon, consultant rheumatologist and director of the rheumatology research unit at Addenbrooke’s, adds: “What we're trying to do is to improve levels of patient understanding of their condition, of the new treatments that they're about to start and how to use them most effectively. Hopefully this will ultimately lead to them understanding their condition better, which will be better for their ability to self-manage it and understand and improve their engagement with healthcare professionals.”

It is hoped the project will also improve adherence to biologic rheumatoid arthritis drugs, which are usually given as injections that the patient self-administers.

“The process can be complex,” says Atherford. “Self-injecting the medicine can be a potentially daunting prospect. If patients could experience this through VR prior to administering the drug for the first time, it may help alleviate stress and improve the patient’s knowledge of the process.”

More than VR

Under the new system, the doctor will prescribe information to patients using the healthinote app, a platform that provides immersive experiences across a range of chronic diseases. The patient will then be able to view the content on a VR headset in the clinic or on their own smartphone or ipad using a simple QR code or link.

“When a patient comes in for an appointment I only have approximately 15 minutes to see them, do their administration and request tests or prescriptions,” Jadon says, explaining the advantages of this approach. “And in my experience, patients don't often read the patient leaflet that I give them.

“At the moment there's also quite a long lag between me proposing the medication and them seeing the specialist nurse, and then them getting their first medication.

“Digital content might be more relatable in terms of the day-to-day things they are looking out for, other day-to-day things. It provides a novel, more interesting way to digest information which may be more pertinent to them.”

But Jadon notes that the programmes like this are not designed to completely replace face-to-face interactions.

“These patients certainly need to have the option to ask questions, take time to digest and also be able to query things at a level that they can understand,” he says.

Implementing VR in a hospital setting

The plan is to have a dedicated room for patients to use the VR headset in immediately after either the consultant or the nurses have proposed the treatment.

“We’ll have two sets of headsets,” says Jadon. “We’re also going to give patients the opportunity to access the content from home using their smartphone.”

Implementation has been relatively straightforward so far, and Jadon notes that there were few challenges thanks to buy in from everyone at the hospital.

“Most of our clinicians are engaged, the nurses are engaged, and the managers have been keen to add another layer of opportunity to educate our patients.”

But the team has made sure they stay aware of the potential pitfalls of technologies like this.

“We’ve tried to make it as autonomous as possible. For example, we've not relied on hospital Wi-Fi because things like that can be prone to issues. We'd like implementation to be as trouble-free as possible. As soon as you start getting IT glitches, both clinicians and patients start to lose confidence.”

The programme has already garnered interest from other hospitals, and Jadon speaks to the potential for this technology in other similar disease areas.

“There's no reason why the model that we're devising for rheumatoid arthritis can't apply to all the other different diseases that we treat, such as psoriatric arthritis, ankylosing spondylitis, lupus, osteoporosis, osteoarthritis.

“We'd also like the project, in time, to be less treatment-related, and have more content for patients at the point when they're diagnosed with these conditions –such as resources about general disease awareness.”

Meanwhile, Atherford says he can see even wider applications.

“Using VR in this way could improve the entire diagnosis process, offering a calm and conducive consultation for both patients and practitioners. This may help to ensure that patients take their medication more effectively.

“We only have to look at the example of patients with dementia using VR to address anxiety and agitation to see that the calming effects of VR show great potential.

“VR is so powerful as it helps to bridge the emotional disconnect between individuals and their bodies. An intense experience in VR, is of course, much more impactful than simply imagining something. This is particularly pertinent when considering smoking and supporting patients with lung cancer, for example. With VR, patients can fully visualise the damage to their lungs, which will hopefully deter them from continuing smoking.”

Jadon concludes: “The more that patients understand about their condition, the better clinical outcomes will be, because they'll know how to safely self-manage their condition. They'll also have a higher trust in the clinical team, and will know that their clinical team is responsive to them.

“If they don't like medication, they don't just need to pretend they're taking it. They can always tell us and we can explore other options, so any potential for more engagement and education is always going to be a good thing.”