EXPLORING THE EFFECTS OF PRESCRIBING AND IMPLEMENTATION TECHNIQUES ON THE ADOPTION OF VIRTUAL REALITY THERAPEUTICS

Anxiety, depression, and pain are among the most prevalent and disabling health conditions globally. Digital therapeutics (DTx), especially virtual reality-based therapeutics (VRx), are emerging as effective non-pharmacological treatments for at-home symptom management. Despite growing evidence of clinical efficacy, widespread adoption of both DTx and VRx in routine care remains limited. To assess the rigor of existing evidence, we systematically reviewed randomized controlled trials evaluating VRx for treating and managing symptoms experienced by cancer patients and survivors. We analyzed research testing VRx as a home-based treatment for various health conditions, mapping the barriers, facilitators, and implementation frameworks. We evaluated clinician and user perspectives through two mixed-methods studies, identifying critical system requirements for VRx dissemination. Using human-centered design, we developed and tested an implementation package, including assistive materials, clinician training, and prescribing tools. We completed a three-arm randomized pilot, assessing acceptability, usability, and fidelity of the implementation package and prescribing VRx in a simulated clinician consultation. Technology acceptance significantly improved across all groups (p < 0.05); usability, acceptability, and fidelity were highest when clinician consultation was included. Findings highlight the critical role of clinicians and impact of structured implementation strategies on the widespread adoption of VRx. This study contributes to implementation science by providing a structured assessment of implementation strategies and outcomes, where empirical testing remains limited. The findings expand evidence on the adoption of DTx by providing a holistic understanding of factors driving implementation success and offering actionable insights for scaling VRx for at-home care. Ultimately, this work provides a framework for making DTx usable, useful, and scalable where patients need care most: at home.