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Respiratory DisorderAVATARNCT05973201

Evaluation of Virtual Reality to Reduce Anxiety, Pain and Duration of Non-emergency Vigile Bronchial Fibroscopy (AVATAR)

A study testing Virtual reality headset in people with Respiratory Disorder and Lung Infection, run by Assistance Publique - Hôpitaux de Paris at 5 sites in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Bronchial fibroscopy (BF) is a routine practice examination in critical care areas. It can be useful either for the diagnosis of the causal pathology of respiratory distress or for the diagnosis of lung infection, sometimes nosocomial. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Respiratory Disorder, Lung Infection
What is being tested?
Virtual reality headset
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
5 sitesFrance
Study dates
19 Oct 2023to 26 Oct 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults (over 18 years of age)
  • Hospitalized in a critical care unit (intensive care and intensive care)
  • Conscious (Glasgow score >13)
  • Spontaneous ventilation
  • Requiring the realization of a FB
  • First BF during hospitalization
  • Having signed a consent to participate in the study
  • Affiliation to social security

Who cannot join

  • Non-French-speaking patient
  • Protected minors or adults who cannot consent to participate
  • People with major neurocognitive impairment
  • Patient refusing to participate in the study
  • Patient on State medical aid
  • Patient under guardianship or curatorship or under judicial protection
Show all 17Show fewer
  • BF for a vital emergency
  • Prior inclusion in the study
  • Pregnant or breastfeeding women
  • Presence of a tracheostomy or tracheostomy
  • Participation in other intervention research
  • Epilepsy
  • Visual impairment (blindness) or severe hearing impairment (hearing loss, deafness) that does not allow the use of the helmet
  • Psychiatric pathologies such as delusional disorders, hallucinations or schizophrenia.
  • Autism spectrum disorders
  • Patient sensitive to motion sickness
  • Refractory migraine under treatment

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

France5 sites, 4 recruiting
  • CHI Aix en Provence

    Aix-en-Provence, 13100

    Youssef TRIGUI, MD, +334 42 33 90 33, ytrigui@ch-aix.fr

    Youssef TRIGUI, MD

    Recruiting
  • CHU Dijon

    Dijon, 21079

    Marjolaine GEORGES, MD, +333 80 29 37 72, marjolaine.georges@chu-dijon.fr

    Marjolaine GEORGES, MD

    Recruiting
  • Hôpital Le Kremlin Bicêtre

    Le Kremlin-Bicêtre, 94270

    Withdrawn
  • Hôpital européen Georges Pompidou - AP-HP

    Paris, 75015

    Alexandra GOMES, Nurse, +331 56 09 25 64, alexandra.gomes@aphp.fr

    Anaïs RASTELLO, Nurse

    Recruiting
  • Hôpital Foch

    Suresnes, 92150

    Floriane Costani, Nurse, +33 1 46 25 29 07, f.costani@hopital-foch.com

    Floriane Costani, Nurse

    Not yet recruiting

Other trials in France

About this study

Official title: Evaluation De La Réalité Virtuelle Pour Réduire L'anxiété, La Douleur Et De La Durée D'une Fibroscopie Bronchique Vigile Non Urgente En Soins Critiques

Bronchial fibroscopy (BF) is a routine practice examination in critical care areas. It can be useful either for the diagnosis of the causal pathology of respiratory distress or for the diagnosis of lung infection, sometimes nosocomial. In patients in spontaneous and conscious ventilation, BF are performed vigil after local anesthesia according to the recommendations of the Société de Pneumologie de langue Française. The good tolerance of the examination and its good conduct may require the use of anxiolytics, sedatives or analgesics to limit the traumatic experience of a highly anxiety-provoking examination. Virtual reality (VR) combines a set of paramedical techniques (hypnosis, music therapy, sophrology) and is now a non-drug alternative to improve the tolerance of certain invasive gestures.VR has been shown to reduce pain and anxiety during first pathways placement or digestive endoscopies. To date, there is no evidence of the benefit of VR when performing semi-urgent BF in critical care areas.

Read the detailed description

Bronchial fibroscopy (BF) is an invasive examination mainly performed in vigilant patients under local anesthesia very regularly performed in patients hospitalized in critical care. Despite local anesthesia, and paradoxically also because of local anesthesia that makes the airflow in the upper airway imperceptible, BF is an anxiety-provoking and sometimes uncomfortable examination. Drug options are offered by physicians on a case-by-case basis and in response to patients' discomfort or anxiety. We believe that a preventive, non-drug strategy would improve comfort, reduce anxiety and improve patients' experience during BF. To reduce anxiety and improve patient comfort, there are non-drug alternatives such as hypnosis, music therapy or virtual reality. Hypnosis requires the availability of previously trained caregivers and a calm environment. Music therapy is difficult to apply in IS because of pre-existing noise pollution. We hypothesize that virtual reality would reduce patient anxiety during a bronchial fibroscopy in bed in critical care, improve the patient and caregiver experience and optimize its realization. Virtual reality (VR) is a technology that allows the patient to be projected, via a computer system, into an immersive virtual world. The patient's immersion in the virtual environment is accompanied by the feeling of "presence" which can be defined as the authentic feeling of existing in a world other than the one where the body is physically located.This specificity, coupled with the ability to isolate the patient's visual and auditory field, make this tool a promising solution to improve the well-being of patients during the care offer. VR is distributed by a set of devices to digitally simulate an environment mobilizing the different senses of its user: sight most often but possibly also touch, hearing or smell. VR, most often distributed via video and audio headset, is a complete immersive experience that can bring together hypnotic scenario and music therapy.

HEALTHY MIND® has designed a VR headset to relieve pain and anxiety in patients in healthcare facilities in a non-drug way. Indeed, this helmet has been developed to exercise analgesic and anxiolytic actions through specific virtual environments by combining different principles such as medical hypnosis, music therapy, light therapy and cardiac coherence. The proposed immersion themes combined with breathing exercises in the initial phase, generate better stress management.

Being tested
Virtual reality headset
Keywords
Virtual reality, Pulmonary fibroscopy, Anxiety, Pain, Intensive care
Medical subject headings
Respiration Disorders, Anxiety Disorders, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Virtual reality headsetDevice

    A HEALTHY MIND® brand VR headset is dedicated to the study. The kit includes a noise-reducing audio headset, a face mask diffusing the visual part, a touchscreen tablet connected to the two VR headset systems, and a microphone connected to the tablet.

    The available software allows patients to choose between 5 natural environments in which a hypnotic speech is broadcast, available in several languages (French, English, Spanish, Russian, Arabic).

Study groups in NCT05973201
Study groupRoleWhat they receive
interventional armExperimentalFibroscopy performed under local anesthesia with immersion in a virtual reality scenario
Receives: Device: Virtual reality headset
Conventional armNo interventionFibroscopy performed under local anesthesia without immersion in a virtual reality scenario

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum value of patient's anxiety experienced during BF assessed by the visual analogue scale (VAS) immediately after the BF

    The visual analogue scale is a rating scale in the form of a 10 cm strip graduated in mm that can be presented horizontally or vertically. On the face presented to the patient, there is a cursor that he mobilizes on a straight line with one end corresponding to "absence of anxiety" and the other to "maximum anxiety imaginable". The patient must then place the cursor where he locates his anxiety. VAS ranges from 0 to 100 mm.

    Measured: Immediately after BF

Secondary outcomes (13)
  1. The relative change of patient's anxiety before and after BF assessed by the STAI-A scale (state anxiety scale)

    The Spielberger State-Trait Anxiety Inventory (STAI) is a 40-item self-report measure of anxiety using a 4-point Likert-type scale (from 1 to 4 points) for each item. It has two scales: State anxiety, i.e. how one feels at the moment; and Trait anxiety, i.e. how one generally feels. Both scales consist of 20 items. The state scale has 10 reverse-scored items, the trait scale has 7. Scores of both scales ranges from 20 to 80.

    Measured: Immediately after BF

  2. Patient's anxiety when leaving the intensive care unit (or on the 7th day at the latest, after BF) assessed by the visual analogue scale (VAS)

    The visual analogue scale is a rating scale in the form of a 10 cm strip graduated in mm that can be presented horizontally or vertically. On the face presented to the patient, there is a cursor that he mobilizes on a straight line with one end corresponding to "absence of anxiety" and the other to "maximum anxiety imaginable". The patient must then place the cursor where he locates his anxiety. VAS ranges from 0 to 100 mm.

    Measured: When leaving the intensive care unit or on the 7th day at the latest, post BF

  3. Maximum value of patient's pain experienced during BF assessed by the visual analogue scale (VAS) immediately after the FB

    The visual analogue scale is a rating scale in the form of a 10 cm strip graduated in mm that can be presented horizontally or vertically. On the face presented to the patient, there is a cursor that he mobilizes on a straight line with one end corresponding to "absence of pain" and the other to "maximum pain imaginable". The patient must then place the cursor where he locates his pain. VAS ranges from 0 to 100 mm.

    Measured: Immediately after BF

  4. Patient's pain experienced during BF evaluated by the nursing staff assessed by the ALGOPLUS scale immediately after the FB

    The ALGOPLUS scale was specifically developed to evaluate and manage acute pain in the elderly in all situations in which reliable self-assessment is not feasible. The scale is composed of 5 items (observational areas/domains). Each item checked "yes" is accorded 1 point and the sum of checked items gives a total score ranging from 1 to 5.

    Measured: Immediately after BF

  5. The relative change of patient's maximum pulse measured during BF compared to pulse measured before BF

    The relative change of patient's maximum pulse measured during BF compared to pulse measured before BF

    Measured: Immediately after BF

  6. The relative change of patient's maximum respiratory rate measured during BF compared to respiratory rate measured before BF

    The relative change of patient's maximum respiratory rate measured during BF compared to respiratory rate measured before BF

    Measured: Immediately after BF

  7. The relative change of patient's maximum blood pressure measured during BF compared to blood pressure measured before BF

    The relative change of patient's maximum blood pressure measured during BF compared to blood pressure measured before BF

    Measured: Immediately after BF

  8. The duration of BF (in minutes) from the start of the local anesthesia to the permanent removal of the fibroscopy

    The duration of BF (in minutes) from the start of the local anesthesia to the permanent removal of the fibroscopy

    Measured: Immediately after BF

  9. Tolerance to the VR assessed by a questionnaire measuring the side effects of the VR

    The questionnaire items lists the side effects of the VR (8 items with 3 answer categories: yes, no and do not know).

    Measured: 1 day post BF

  10. Patient anxiety experienced before BF evaluated by the nursing staff assessed by Hamilton scale

    The Hamilton Anxiety Rating Scale (HAM-A) is a psychological questionnaire used by clinicians to rate the severity of a patient\'s anxiety.The scale consists of 14 items designed to assess the severity of a patient\'s anxiety.

    Measured: Before BF

  11. The total dose of sedative and anxiolytic drugs administered during BF

    The total dose of midazolam, alprazolam, hydroxyzine, diprivan, stage II or III analgesics administered during BF

    Measured: Immediately after BF

  12. The quality of FB (specific questionnaire completed by the physician describing the quality of exploration, the possibility of taking samples and the satisfaction VAS).

    A specific questionnaire completed by the physician in charge of the BF will be used describing the quality of the exploration and the possibility of taking samples

    Measured: Immediately after BF

  13. Remote patient satisfaction with FB measured using the e-SATIS ?questionnaire (Haute Autorité de Santé "prise en charge" section), and the answer to the single question: "Would you have a bronchial fibroscopy again in the future)

    E-SATIS is an experience and satisfaction questionnaire, in which all patients are invited to participate, following treatment in a health establishment, hospital or clinic. The questionnaire is validated by the French Haute autorité de santé. The \"patient care\" section of the questionnaire was used to assess remote patient\'s satisfaction on the BF procedure. For each responding patient, a score ranging from 1 [bad experience] to 5 [excellent experience] (transformed into a value from 0 to 100) is given to each of his answers.

    Measured: 7 days post BF

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Aug 2023
  2. Study start19 Oct 2023
  3. Primary completion19 Oct 2025 (estimated)
  4. Study completion26 Oct 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Patients in whom elective BF has been scheduled and who have given consent to the study will be randomised (1:1) to either the control group (BF after local anaesthesia (LA)) or the experimental group (BF after AL and VR immersion). Randomization will be done 30 minutes before BF, after an initial assessment of anxiety (pre-BF VAS) and will be stratified according to whether or not a psychotropic drug and/or a level II analgesic is taken the day before or on the day of BF. The randomization list will be programmed in advance by the study statistician using SAS software and will be generated and edited by another statistician independent of the study from the HEGP clinical research unit. The randomization list will be kept by the study sponsor (AP-HP). It will be available to users via web-based software (CleanWeb software (Telemedicine Technologies, http: //www.tentelemed.com/la-solution-cleanweb/)\].
Masking
None (open label)
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05973201
Sponsor's protocol ID
APHP220834
Other IDs
PHRIP-21-0055, 2023-A00163-42
Acronym
AVATAR
Status last verified
Sep 2024
First submitted
26 Jul 2023
Last updated
4 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data (IPD) that underlie results in publication could be shared. IPD detailed in the protocol of a planned metaanalysis could be shared

Questions about this trial

What is this clinical trial studying?

A study testing Virtual reality headset in people with Respiratory Disorder and Lung Infection, run by Assistance Publique - Hôpitaux de Paris at 5 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 4 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Aurélie ZINDJIRDJIAN (+33 1 44 84 17 64, aurelie.zindjirdjian@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum value of patient's anxiety experienced during BF assessed by the visual analogue scale (VAS) immediately after the BF (time frame: Immediately after BF). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Dec 2024.

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