Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 24, 2021
Open Peer Review Period: May 24, 2021 - Jul 19, 2021
Date Accepted: Dec 13, 2021
(closed for review but you can still tweet)
The use of gamification and incentives in mobile health apps to improve medication adherence: a scoping review
ABSTRACT
Background:
Emerging healthcare strategies to address medication adherence include the use of direct-to-patient incentives or elements adapted from computer games. However, there is currently no published evidence synthesis on the use of gamification and/or financial incentives in mobile applications (apps) to improve medication adherence.
Objective:
To explore the use of gamification and/or financial incentives in mobile apps to improve medication adherence.
Methods:
The following databases were searched for relevant articles published in English up to 24th of September: Embase, MEDLINE, PsycINFO, CINAHL and Web of Science. Arksey and O’Malley’s framework and the PRISMA-ScR checklist guided this systematic scoping review. Using a systematic screening process, studies were included if incentives and/or game features were used in mobile apps to address medication adherence.
Results:
An initial 691 potentially relevant articles were retrieved. Using a systematic process, 11 studies were included in this review. Across the studies, gamification alone (n=9) was used more than financial incentives (n=1) alone or a combination of the two (n=1). There was great variability in the development of the apps and underpinning theories. Patient involvement and contributions were not commonly seen in predevelopment but were evident in evaluations of feasibility, acceptance and effectiveness. The studies generally reported improved or sustained optimal medication adherence outcomes with gamification and financial incentives; however, there were significant heterogeneity in the patient population, methodology such as outcome measures and reporting of these studies.
Conclusions:
To address medication adherence via gamified and incentivised mobile apps, an evidence-based co-design approach and agile methodology should be used during development. Further research in a generalised cohort of patients living with chronic conditions would facilitate the identification of barriers and potential opportunities for the use of gamification and financial incentives in mobile apps for medication adherence.
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