• Jiping Mo, Victoria Vickerstaff, Ollie Minton, Simon Tavabie, Mark Taubert, Patrick Stone, and Nicola White.
• UCL Division of Psychiatry, London, UK.
• Palliat Med. 2022 Jul 1; 36 (7): 104710581047-1058.

BackgroundThe efficacy of virtual reality for people living with a terminal illness is unclear.AimTo determine the feasibility and effectiveness of virtual reality use within a palliative care setting.DesignSystematic review and meta-analysis. PROSPERO (CRD42021240395).Data SourcesMedline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to March 2021. Search terms included 'virtual reality' and 'palliative care'. Eligibility: (1) adult (>18 years old) with a terminal illness (2) at least one virtual reality session and (3) feasibility data and/or at least one patient outcome reported. The ROB-2 and ROBINS tools assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool assessed the quality of the evidence. Standardised mean differences (Hedges's g) were calculated from the pre- and post-data. A DerSimonian-Laird random effects model meta-analysis was conducted.ResultsEight studies were included, of which five were in the meta-analysis. All studies had at least some concern for risk of bias. Virtual reality statistically significantly improved pain (p = 0.0363), tiredness (p = 0.0030), drowsiness (p = 0.0051), shortness of breath (p = 0.0284), depression (p = 0.0091) and psychological well-being (p = 0.0201). The quality of the evidence was graded as very low due to small sample sizes, non-randomisation methods and a lack of a comparator arm.ConclusionsVirtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research.

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