Designing and Evaluating Digital Therapeutic Interventions Using Virtual and Augmented Reality to Improve Medication Adherence, Patient Education, and Chronic Disease Self-Management

Background: Chronic diseases such as diabetes, hypertension, and COPD are leading causes of global mortality, yet conventional approaches to patient education and medication adherence remain insufficient. Emerging technologies like virtual reality (VR) and augmented reality (AR) offer immersive, interactive platforms with potential to transform chronic disease self-management, though rigorous clinical evidence remains limited. Objective: This study aimed to evaluate the effectiveness of VR/AR-based digital therapeutic interventions in improving medication adherence, disease-specific knowledge, and self-management behavior among patients with chronic conditions. Methods: A 6-month randomized controlled trial (n = 200) with a mixed-methods explanatory design was conducted involving adults aged 18–80 diagnosed with diabetes, hypertension, or COPD. Participants were randomized into intervention (VR/AR) and control (standard care) groups. Clinical outcomes (HbA1c, BP, FEV1), adherence (smart dispensers, refill logs), and healthcare utilization (EHR records) were assessed alongside usability (System Usability Scale) and behavioral insights (interviews, focus groups). Ethical approval was obtained (IRB# AJKU-PH2024/01), and informed consent was secured per the Helsinki Declaration. Statistical analysis was performed using SPSS v27, applying ANOVA, regression models, and subgroup analyses. Results: VR/AR interventions led to a 15.6% HbA1c reduction (p < 0.001), 12.8% systolic BP decrease (p = 0.003), 22% fewer COPD hospitalizations (p = 0.02), and 32% higher adherence (p < 0.001). AR showed higher usability (SUS 82/100), particularly among older adults. Conclusion: Immersive VR/AR interventions significantly improve chronic disease management by enhancing adherence, clinical outcomes, and patient engagement. AR proves high usability and scalability for real-world healthcare applications.