From innovation to implementation: a case report on virtual reality for chronic pain and psychological well-being in clinical practice.

BACKGROUND/OBJECTIVES: Virtual reality (VR) is an emerging non-pharmacologic intervention for chronic pain management among Veterans. Although randomized controlled trials have demonstrated the efficacy of skills-based VR interventions such as RelieVRx for reducing pain and anxiety, less is known about how these interventions can be implemented within real-world interdisciplinary care settings in the Caribbean or how they influence patient engagement and psychological outcomes in routine practice. This case series aims to describe real-world implementation and patient-level outcomes with Veterans in the Caribbean. MATERIALS AND METHODS: This case report describes the adoption of RelieVRx into the Interdisciplinary Pain Rehabilitation Program (IPRP) at the VA Caribbean Healthcare System. Data from three bilingual Veterans with chronic pain who participated in the IPRP and completed 56 sequential RelieVRx sessions were analyzed for changes in subjective pain levels, anxiety, and depressive symptoms. Veterans' qualitative experiences with the device were also assessed. RESULTS: Clinical adoption of RelieVRx involved identification of appropriate clinicians, alignment with existing workflows, staff training and competency verification, a supervised trial period, standardized documentation of use, and ongoing performance monitoring. All three Veterans reported improvements in mood following RelieVRx use. Two Veterans reported reductions in subjective pain levels, while pain levels remained unchanged for one Veteran. Improvements in depressive and anxiety symptoms were observed in two Veterans, while qualitative reports suggested enhanced emotional regulation across all cases. CONCLUSIONS/DISCUSSION: RelieVRx appears to be a feasible adjunct to interdisciplinary pain care intervention. This report highlights real-world implementation and patient-level experiences rather than establishing causal effectiveness. In addition to perceived improvements in pain, Veterans reported benefits in mood. Participants also described sustained usefulness of the device beyond the structured 56-session intervention, extending into their daily lives.