“Your Digital Doctor Will Now See You”: A Narrative Review of VR and AI Technology in Chronic Illness Management

Abstract

Highlights: What are the main findings? Immersive VR/MR and AI-driven virtual agents can significantly enhance engagement, motivation, and emotional well-being in patients with chronic illnesses by providing adaptive, personalized, and interactive therapeutic experiences. Despite their promise, these technologies face notable challenges, including technical limitations (e.g., latency, system dependence), ethical concerns (e.g., data privacy, algorithmic bias), and psychosocial risks (e.g., emotional over-attachment or discomfort from overly human-like avatars). What are the implications of the main findings? Integrating VR/MR and AI into a unified tool for chronic illness management requires patient-centered design, clinician oversight, and transparent governance frameworks to ensure safety, empathy, and accessibility. When implemented responsibly, these technologies can complement traditional therapy by reducing treatment burden, supporting self-management, and improving long-term adherence and quality of life for patients with chronic conditions. This narrative review examines how immersive virtual and mixed-reality (VR/MR) technologies, combined with AI-driven virtual agents, can support the prevention and long-term management of chronic illness. Chronic diseases represent a significant global health burden, and conventional care models often struggle to sustain patient engagement, motivation, and adherence over time. To address this gap, we conducted a narrative review of reviews and meta-analyses. We selected empirical studies published between 2020 and 2025, identified through searches in PubMed, Web of Science, and Google Scholar. The aim was to capture the state of the art in the integrated use of VR/MR and AI in chronic illness care, and to identify key opportunities, challenges, and considerations relevant to clinical practice. The reviewed evidence indicates that VR/MR interventions consistently enhance engagement, motivation, symptom coping, and emotional well-being, particularly in rehabilitation, pain management, and psychoeducation. At the same time, AI-driven conversational agents and virtual therapists add adaptive feedback, personalization, real-time monitoring, and continuity of care between clinical visits. However, persistent challenges are also reported, including technical limitations such as latency and system dependence, ethical concerns related to data privacy and algorithmic bias, as well as psychosocial risks such as emotional overattachment or discomfort arising from avatar design. Overall, the findings suggest that the most significant clinical value emerges when VR/MR and AI are deployed together rather than in isolation. When implemented with patient-centered design, clinician oversight, and transparent governance, these technologies can meaningfully support more engaging, personalized, and sustainable chronic illness management.