JMIR Publications

ABSTRACT

Background:

The aim of this systematic review was to summarize and evaluate current evidence on the effectiveness of digital health interventions containing game components on behavioral, patient-reported and clinical outcomes for patients with type 2 diabetes.

Objective:

The aim of this systematic review was to summarize and evaluate current evidence on the effectiveness of digital health interventions containing game components on behavioral, patient-reported and clinical outcomes for patients with type 2 diabetes.

Methods:

An electronic search was conducted in Medline and PsycINFO in April 2020, updated in April 2022 and supplemented by additional searches via Google scholar, Web of Science, and within the references of the included records. Articles were identified using predefined inclusion and exclusion criteria. In total, two reviewers independently conducted the title, abstract, and full-text screening and then individually performed a quality assessment of all included studies. Consensus was achieved through discussion.

Results:

Out of 2,325 potentially relevant titles (duplicates excluded), 11 studies were included. The Cochrane Risk of Bias Tool 2 for quality assessment of randomized controlled trials revealed a high risk of bias for all studies except two. Evidence suggests that digital health interventions containing game components can significantly improve motivation for physical activity (n = 1 study), exercise intensity (n = 3), dietary behavior (n = 3), health literacy (n = 1), mental quality of life (n = 2), as well as HbA1c (n =2), Body Mass Index (n = 1), Fasting Plasma Glucose (n = 1), waist circumference (n = 1) and aerobic capacity (n = 1).

Conclusions:

Published studies indicated that digital health interventions containing game components might improve health behavior patterns, quality of life and clinical outcomes of patients with type 2 diabetes. However, intervention types as well as outcomes studied were heterogeneous and study quality was mostly low, which translates to ambiguous results. Future research should focus on sound methodology and reporting, as well as on identifying game components that contribute to significant positive effects.