Effectiveness of virtual reality interventions to reduce pre-operative anxiety in adult surgical patients in the pre-operative period: Systematic review and meta-analysis

Abstract

Aims: To synthesise and evaluate the effectiveness of virtual reality (VR) interventions compared to standard care to reduce pre-operative anxiety in adult surgical patients during the pre-operative period. Design: Systematic review of effectiveness and meta-analysis. Data sources: MEDLINE, EMBASE, JBI EBP, PUBMED, CINAHL, SCOPUS, PsycINFO, Cochrane Library, EMCARE, World Health Organisation, WEB OF SCIENCE, Grey Literature, National Institute of Health & Care Excellence were searched with limits between 2010 to 2022. Review methods: The review followed the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) guidelines. Two independent reviewers conducted the selection, critical analysis, data extraction and critical appraisal using the JBI Critical Appraisal Checklist for Randomised Controlled Trials. Data was synthesised through meta-analysis using random effect model in RevMan 5 software (version 5.4.1) and narrative syntheses. Results: This analysis included data from five studies with a combined total of 466 adults. The meta-analysis of the included studies suggested positive outcomes (SMD = -0.18 [-0.37, 0.00]) of VR interventions compared to standard care in managing anxiety in pre-operative adult patients. The pooled results showed statistically significant difference (p-value <0.001; I2 =69%) with no substantial heterogeneity in effects among the included studies. The null hypothesis was thus rejected and it was concluded that, on average, the VR intervention does decrease anxiety in the universe of populations comparable to those in the analysis. Similarly, all the independent studies also indicated that VR interventions were favorable in the reduction of preoperative anxiety in adult surgical patients, though the statistical significance was not overwhelming. Conclusion: The primary evidence on the effectiveness of VR interventions to manage pre-operative anxiety, though limited, is increasing and substantiates the need for more rigorous research to optimise its application in adults.