Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 16, 2020
Date Accepted: Jun 3, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Effects of a Digital Therapeutic Utilizing Gamification and Incentives to Achieve Optimal Medication Adherence: Retrospective Analysis
ABSTRACT
Background:
Strategies to improve medication adherence have been widespread and effective in the literature, yet their impact is limited in real practice with patient adherence levels staying consistently low at 50%. Few patients persistently engage long-term to improve health outcomes, even when aware of the consequences of poor adherence. With an estimated 68% of patients using a mobile health application, digital gamification and incentives may be a solution to use extrinsic, short-term rewards to create intrinsic, long-term motivation toward better health and adherence.
Objective:
The objective of this study was to analyze the impact over time of an already implemented digital therapeutic utilizing multiple components within a mobile app including gamification, incentives, reminders, education, and a social community on medication adherence rates in adults with any condition.
Methods:
A retrospective observational study was performed to asses adherence rates of patients with any chronic condition using Perx Health, a digital therapeutic that utilizes multiple components within a mobile health app to improve medication adherence. These include gamification, dosage reminders, incentives, education and social community components. Adherence was measured through Mobile Direct Observation of Therapy (M-DOT) over a 3 month and 6 month time period. Data was analyzed for implementation adherence defined as the percentage of doses on which the correct dose of the medication(s) was taken in addition to timing compliance, or percentage of doses taken at the appropriate time (+/- one hour).
Results:
Patients using the app for 3 months and 6 months were analyzed with 243 and 130 users included, respectively. The average age was 43.8 years (SD 15.5) and 64.2% (n=156) were female. The most common medications prescribed were varenicline, rosuvastatin and cholecalciferol. Implementation adherence averaged at 84.6% (SD 20.9%) over 3 months and 87.6% (SD 16.9%) over 6 months. Timing compliance included 221 users’ over 3 months and 111 over 6 months, averaging at 61.1% (SD 28.5%) and 68.5% (SD 29.1%) respectively.
Conclusions:
Retrospective analysis of the Perx digital therapeutic incorporating incentives, gamification, education, reminders and social community components revealed an effective intervention to achieve and maintain optimal medication adherence over time. Mobile technology utilizing these theories are an effective intervention in increasing patient engagement and improving medication adherence.
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