Anxiety disorders are highly prevalent and disabling conditions. They cause feelings of incapacitating fear for individuals, and cost society 74.4 billion Euro per year in Europe alone.
Exposure therapy (ET) involves gradually exposing the patient to the object or situation that they fear. It is effective, but also time-consuming, expensive and difficult to control. Virtual reality exposure therapy (VRET) offers a safe, controlled, cost-effective and potent alternative. Using a computer-generated environment, VRET gradually immerses the patient in an emotional experience. However, current VRET solutions struggle to correctly assess the patient’s real-time anxiety level during exposure and are difficult to personalize. Moreover, VRETs are often standalone, complex solutions, which complicates longitudinal, long-term follow-up based on blended self-care and therapist involvement. Mobile apps for anxiety do exist, but don’t include the therapist in the daily follow-up and coaching loop.
PATRONUS sought to develop a portfolio of IT tools that provides personalized, blended, emotion-aware support to therapists and patients throughout the entire anxiety treatment process.
The PATRONUS consortium brought together experts in ET (The Human Link), VR & mobile development (PreviewLabs & Bazookas), scalable data processing (Van Roey), data analytics hardware and software (imec-CHS & IDLab), and patient-centered services (mict). They aimed to create a blended care solution that provides an accurate and continuous view of the patient’s anxiety level (supported by physiological information from a wearable device and subjective values from the patient) throughout treatment. Easy to control and personalize, it would support longitudinal follow-up between sessions through home-based VR therapy exercises and a motivational mobile coaching application.
PATRONUS’s cloud-based solution consists of four main components. The first is an immersive virtual reality environment for claustrophobia and panic disorders, which can be personalized to the patient’s profile. The second is a low-cost mobile application enabling the patient to perform VR exercises at home and allowing therapists to conduct longitudinal follow-up. Third is a comprehensive dashboard, enabling therapists to easily configure the VR environment and mobile application. Fourth is a scalable data analytics cloud platform, enabling seamless integration of data collected from a wearable device and delivering real-time insights to the therapists about the patient’s condition.
A detailed study investigated how data collected through wearables such as the imec Chillband+ and Empatica E4 could be used to enhance the exposure therapy. An algorithm was designed to assess fear objectively, based on the data collected from the patient’s wearable during therapy. The therapist can use this assessment as an extra tool to steer therapy - in addition to the subjective fear assessments provided by the patients themselves. Secondly, the project team created a data analytics algorithm that provides the therapist with suggestions on how to configure the VR environment for the therapy session. Suggestions are based on the patient’s profile collected through clinically validated questionnaires, previous exercises and reported fear levels. This greatly simplifies configuration for the therapists, allowing them to focus on the therapy instead of the tools.
The project also designed guidelines and protocols that show therapists how best to integrate the IT tools into the exposure therapy to enable optimal blended care. A user study revealed that the majority of therapists reacted positively to the user-friendliness of the dashboard. In addition, the blended care solution and guidelines were clinically validated by therapists from The Human Link, working with their patients, to assess their effectiveness.