Gamification for Medication Adherence in High Blood Pressure and Cholesterol

Overseen By Kayla Clark, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pennsylvania

Must be taking: Blood pressure, Statins

Disqualifiers: Cognitive barriers, Life expectancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 18 weeks

84 Participants Needed

Trial Summary

What is the purpose of this trial?

A two-arm randomized controlled trial to evaluate whether a gamification intervention plus involvement of a supportive partner (social support) and sending reports to physicians (accountability) increases medication adherence in patients with hypertension and hyperlipidemia. The study will randomize 84 patients with hypertension, hyperlipidemia, and a history of poor medication adherence seen in a single Penn Medicine clinic to an 18-week gamification intervention or to attention control text messages alone.

Do I need to stop my current medications for this trial?

The trial does not require you to stop your current medications. In fact, you need to have been prescribed blood pressure and statin medications for over a year to participate.

What data supports the effectiveness of gamification for medication adherence in high blood pressure and cholesterol?

Research shows that using games and social support can help people stick to their medication plans. For example, a study found that a smartphone app using video chats motivated heart disease patients to take their medicine regularly. ^{1 2 3 4 5}

Is gamification for medication adherence safe for humans?

The research on gamification for medication adherence, including studies on rheumatoid arthritis and antibiotic use, does not report any safety concerns, suggesting it is generally safe for humans. ^{1 2 4 6 7}

How does the gamification treatment for medication adherence in high blood pressure and cholesterol differ from other treatments?

This treatment is unique because it uses gamification (applying game-like elements) to encourage patients to stick to their medication schedule by offering real-world rewards and video feedback, which is different from traditional methods that don't typically incorporate these engaging, interactive elements. ^{1 3 4 8 9}

Research Team

Alexander Fanaroff, MD, MHS

Principal Investigator

University of Pennsylvania

Eligibility Criteria

This trial is for patients with high blood pressure and cholesterol who have struggled to take their medications regularly. They must own a smartphone, have had a recent blood pressure reading over 140 mm Hg, been on specific meds for over a year, and not taken them as prescribed in the last 6 months. Those with very high blood pressure or less than 6 months to live cannot join.

Inclusion Criteria

Owns a smartphone or tablet operating the iOS or Android operating system

Your blood pressure is consistently higher than 140 mm Hg when checked.

I have my medications available now.

Exclusion Criteria

Your blood pressure was very high at your last checkup.

Any other reason why it is not feasible to complete the entire study

It is expected that you will live for less than 6 months.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a gamification intervention or attention control text messages to improve medication adherence

18 weeks

Daily virtual check-ins via text messages

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• HTN and Medication Adherence

Trial Overview The study tests if adding game-like elements (gamification) to treatment, along with support from friends or family and reporting to doctors can help patients stick to their medication schedules better than just getting reminder texts.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

Via the Way to Health platform, all patients will receive daily text messages asking about medication adherence for that day and twice weekly text messages asking if participants have measured blood pressure on that day. Participants are entered into a game. Each week they receive 90 points. If they took their medications or checked their blood pressure the prior day, they keep their points, but if not, they lose 10 points. At the end of the week if they have at least 70 points they move up a level, but if not, they drop a level. Participants start in the middle of 5 levels. Participants choose a support partner. At the start of the intervention, the study team holds a 3-way phone call with the participant and support partner to discuss ways they can help the participant meet their goal. The support partner gets a weekly email with the participant's progress. Primary care physicians will receive a monthly email noting patients' self-reported adherence and blood pressure.

Group II: Control Active Control 1 Intervention

Via the Way to Health platform, all participants will receive daily text messages asking about medication adherence for that day and twice weekly text messages asking if participants have measured blood pressure on that day.

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

Findings from Research

Non-adherence to treatment is a significant issue in healthcare, costing the US over $100 billion annually in avoidable healthcare expenses and an additional $230 billion in lost productivity.

The proposed framework combines gamification techniques with real-world rewards to enhance patient motivation and adherence, implemented through modifications to a health tracking app and video feedback on potential rewards.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing Health Care Adherence Through Gamification, Video Feedback, and Real-World Rewards. Saric, K., Redd, C., Varnfield, M., et al.[2020]

References

1. Canada pubmed.ncbi.nlm.nih.gov

A Serious Puzzle Game to Enhance Adherence to Antirheumatic Drugs in Patients With Rheumatoid Arthritis: Systematic Development Using Intervention Mapping. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial. [2023]

3. China pubmed.ncbi.nlm.nih.gov

Pilot study of a smartphone application designed to socially motivate cardiovascular disease patients to improve medication adherence. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Increasing Health Care Adherence Through Gamification, Video Feedback, and Real-World Rewards. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Medication adherence among rural, low-income hypertensive adults: a randomized trial of a multimedia community-based intervention. [2021]

6. Canada pubmed.ncbi.nlm.nih.gov

An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Antimicrobial Resistance: Protocol of a Randomized Controlled Trial. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Designing Feedback Visualizations for Anti-Hypertensive Medication Adherence for Older Adults. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Understanding and assessing gamification in digital healthcare interventions for patients with cardiovascular disease. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Gamification in a Physical Activity App: What Gamification Features Are Being Used, by Whom, and Does It Make a Difference? [2022]