Life science
Medical & healthcare, Smart devices, Virtual reality

Using virtual reality for better healthcare
Department of Clinical Pharmacy Research and Education, Graduate School of Pharmaceutical Sciences
Assistant Professor Kazuyuki Niki
Researchmap https://researchmap.jp/kazuyuki_niki

Life science

Abstract
With the aging of the population, the increase in the number ofcancer patients and dementia patients has become a global problem. In addition, digital transformation (DX) is currently advancing
rapidly in various fields due to the influence of the COVID-19, anddigital therapeutics are attracting attention in the medical field.
Therefore, I try to improve the QOL of cancer patients and develop
new methods to prevent dementia by practicing digital therapeutics using virtual reality (VR).

▍ Background & Results
Many terminal stage cancer patients wish to go back to theirmemorable places, but due to the burden of various symptoms andespecially recently due to the COVID-19, it is sometimes impossible to realize their wishes. Therefore, I conducted a clinical trial
with the idea that if I could simulate the patients’ wishes by usingVR, it would lead to an improvement in QOL (Fig. 1). As a result,significant improvements were observed in pain, fatigue, drowsiness, breathlessness, depression, anxiety, and well-being (Fig.
2). On the other hand, no serious adverse reactions such wereobserved. Furthermore, the patients who went to the memorable
places by VR showed significant improvements in many symptoms,
but, there was no significant improvement in the patients who went
to the places they had never been but wanted to go (Fig. 3).
From these results, I believe that it is important to "bring backmemories" and I have started to develop a dementia prevention
method using VR. One of the most common non-drug therapies fordementia is the reminiscence. I hypothesized that a VR environment with a sense of immersion and realism would make the reminiscence more effective, so I first focused on the behavioral andpsychological symptoms of dementia (BPSD) and piloted the effectiveness and safety of VR-based reminiscence. As a result, I foundthat the VR-based reminiscence significantly reduced anxiety inlate-stage elderly people and that there were no serious adversereactions.

Figure 1. A patient experiencing VR

Figure 2. Changes in physical and mental symptoms before and after the VR travel▍ Significance of the research and Future perspective
I am the first person in the world to report that the use of VR improves various physical and mental symptoms of terminal cancer
patients. This report has been widely cited, and I have received
consultations about the introduction of VR into medical care not
only from Japan but also from overseas, and I feel that it is becoming popular. I also suggest the effectiveness of VR-based
reminiscence for BPSD. It is important to note that I discover thepossibility that use of VR can lead to the realization of better medical care, and I believe that these findings are of great significancefor the present and the future, when DX is accelerating further inthe with and post COVID-19 era. From the standpoint of medical
professionals, I will continue to examine the possibilities of digital
therapeutics using various smart devices, including VR.

Figure 3. Analysis by VR travel destination

P a t e n tNiki, K; Okamoto, Y; Maeda, I. et al. A Novel Palliative Care Approach Using Virtual Reality for Improving Various Symptoms of Terminal Cancer Patients: A Preliminary Prospective, Multicenter Study. J Palliat Med. 2019; 22(6): 702-707. doi: 10.1089/jpm.2018.0527.
Niki, K; Okamoto, Y; Maeda, I. et al. Responses to Kako et al. (doi: 10.1089/jpm.2019.0072) and Niki et al. (doi: 10.1089/jpm.2018.0233): A Novel Palliative Care Approach Using Virtual Reality for Improving Various Symptoms of Terminal Cancer Patients: A Preliminary Prospective, Multicenter Study. J PalliatMed. 2019; 22(12): 1490. doi: 10.1089/jpm.2019.0487.
Tr e a t i s e
Niki, K; Okamoto, Y; Ueda, M; Response to Wang et al., Virtual Reality as a Bridge in Palliative Care during COVID-19（doi: 10.1089/jpm.2020.0212). J Palliat Med. 2020; 23(7): 892-894. doi: 10.1089/jpm.2020.0261.
Yahara, M; Niki, K; Ueno, K. et al. Remote Reminiscence Using Immersive Virtual Reality May Be Efficacious for Reducing Anxiety in Patients with Mild Cognitive Impairment Even in COVID-19 Pandemic: A Case Report. Biol Pharm Bull. 2021; 44(7): 1019-1023. doi: 10.1248/bpb.b21-00052.
Niki, K; Yahara, M; Inagaki, M. et al. Immersive Virtual Reality Reminiscence Reduces Anxiety in the Oldest-Old Without Causing Serious Side Effects: A Single-Center, Pilot, and Randomized Crossover Study. Front Hum Neurosci. 2021; 14: 598161. doi: 10.3389/fnhum.2020.598161.
URL https://phs-osaka-u-ryouyaku.jimdofree.com/K e y w o r d virtual reality, digital therapeutics, palliative care, dementia, clinical research