The PBR theorem asserts that quantum states must correspond to real physical entities rather than being mere statistical tools, or else all quantum states, including non-entangled ones, would imply action at a distance. This claim challenges the instrumentalist view that considers quantum states as purely predictive. The theorem strengthens the de-Broglie-Bohm theory against other hidden variable theories by establishing that certain aspects of it are necessary for any hidden variable framework. However, it does not rule out epistemic interpretations of quantum states, which suggest that quantum states can be understood without assuming underlying hidden variables. The discussion highlights the ongoing debate about the implications of the PBR theorem for quantum mechanics interpretations.