Accepted for/Published in: JMIR Serious Games
Date Submitted: Mar 9, 2023
Date Accepted: Mar 17, 2024
Using games to simulate medication adherence and non-adherence: An application of Gamified Behavioral Simulation
ABSTRACT
Background:
There is consistent evidence that non-adherence is a significant problem associated with worse clinical outcomes, higher downstream re-hospitalization rates and a higher use of resources. A potential innovative strategy that has been found successful at improving patient medication adherence is the use of gamification.
Objective:
The study carries out a behavioural diagnosis of the medication adherence problem through a theoretically informed framework and then develops a gamification platform to simulate the non-adherence behaviour.
Methods:
A lab experiment was conducted, using a modified popular and addictive open-source video game called ‘2048’, which created an abstract model for the medication adherence behaviour observed in real life. Five hundred and nine participants assigned to the control and the four intervention groups (“incentive” group, “reminder” group, “commitment device” group and “elongated duration for symptoms” group).
Results:
The results of the modelling experiment showed that having theoretically informed interventions can increase the likelihood for them to be successful. In particular, there is evidence that the use of reminders improves the medication adherence rates for patients, and the same result was found in the modelling experiment. However, providing an incentive didn’t improved the adherence rate. We also tested the use of commitment devices, which, in line with real-world evidence, did not improve adherence rates. The fourth treatment tested elongated duration for symptoms, which attempted to show the power of modelling experiments where we test a ―what-if ―scenario that is extremely difficult to test in a real setting. The results indicated that if symptoms last longer, people didn’t adhere more to their medication regimen.
Conclusions:
Gamified behavioural modelling, especially by using reminders, could be consider as a useful tool to explain real health behaviours and help in identifying which interventions are most likely to work in a randomised trial.
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