315: Virtual Reality for Procedural Pain and Anxiety in Patients with ?-Thalassemia in the UAE

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Non-pharmacological treatments, Digital Health Technologies , Pain in Special Populations

Background and Aims: Patients with β-thalassemia undergo lifelong, repeated intravenous cannulations, often resulting in procedural pain, anticipatory anxiety, and cumulative psychological distress (1,2). Virtual reality (VR) has emerged as a non-pharmacological intervention capable of modulating attentional and emotional pain pathways (3). This study aimed to evaluate the effectiveness, feasibility, and tolerability of therapeutic VR as an adjunct to standard care in reducing pain- and anxiety-related outcomes during routine cannulation in patients with β-thalassemia in the United Arab Emirates.

Methods: A prospective crossover study was conducted among 115 patients aged ≥8 years undergoing routine intravenous cannulation. Participants received standard of care (SOC) during the first visit, followed by VR-assisted cannulation during two subsequent visits. The VR sessions consisted of medical-grade therapeutic immersions with various environments, available in both Arabic and English. These included elements of guided breathing and hypnosis, tailored for use in invasive procedures. Pain, anxiety, fatigue, and boredom were assessed after each session using validated visual analogue scales. Physiological parameters, patient satisfaction, and adverse effects were recorded. Outcomes compared between VR and SOC sessions using paired statistical analyses.

Results: Reported anxiety was significantly lower in the VR group 2.24 (±2.6) than in SOC 2.92 (±2.3), (p=0.02). Fatigue was also significantly lower in the VR group 1.67 (±1.3) vs 2.65 (±2.2) in SOC group (p=0.01). Mean pain scores were lower during VR-assisted cannulation, though the difference did not reach statistical significance, likely reflecting low baseline pain levels in patients accustomed to frequent procedures. VR also significantly reduced boredom and was well tolerated, with no reported adverse effects. Patient satisfaction ratings were consistently high across VR sessions.

Conclusions: Therapeutic VR is a safe, feasible, and patient-preferred non-pharmacological adjunct that improves the procedural experience of patients with β-thalassemia by reducing anxiety and other affective contributors to pain. While pain intensity reductions were modest, VR meaningfully addressed psychological dimensions of procedural burden in a region where thalassemia is highly prevalent. This study highlights the value of culturally adaptable, technology-based interventions in regions with a high burden of inherited disease, and for populations exposed to lifelong, repetitive invasive procedures, supporting the integration of VR into comprehensive pain management strategies.

References: 1. Tedone F, Lamendola P, Lopatriello S, Cafiero D, Piovani D, Forni GL (2021) Quality of Life and Burden of Disease in Italian Patients with Transfusion-Dependent Beta-Thalassemia. J Clin Med 11(1):15. 10.3390/jcm11010015
2. Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer MA, Rourke M (2006) An integrative model of pediatric medical traumatic stress. J Pediatr Psychol 31(4):343–355. 10.1093/jpepsy/jsj054
3. Li A, Montaño Z, Chen VJ, Gold JI. Virtual reality and pain management: current trends and future directions. Pain Manag. 2011;1(2):147-157. 10.2217/pmt.10.15

Presenting Author: Sameer Asim Khan
Submitting Author: Sameer Asim Khan

Senior Author: Yacine Hadjiat

IASP 2026 Global Year theme of Neuropathic Pain: No

• Fawaz Shefeek Mohammed: MD student - Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health
• Humza Iqbal Rathore: MD student - Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health
• Ahmed Soliman: MD - Dubai Thalassemia Center, Dubai Health
• Bushra Alfugair: MD - Dubai Thalassemia Center, Dubai Health
• Fatheya Alkhaja: MD - Dubai Thalassemia Center, Dubai Health
• Yacine Hadjiat: MD, MBA, PhD - Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health and National Institute of Health and Medical Research (INSERM, U987)