TY - JOUR
T1 - Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study
T2 - A randomised controlled trial
AU - Pouls, Bart P. H.
AU - Bekker, Charlotte L.
AU - Gundogan, Fatma
AU - Hebing, Renske C. F.
AU - van Onzenoort, Hein A. W.
AU - van de Ven, Liesbeth I.
AU - Vonkeman, Harald E.
AU - Tieben, Rob
AU - Vriezekolk, Johanna E.
AU - van Dulmen, Sandra
AU - van den Bemt, Bart
N1 - Funding Information: This work was supported by AbbVie Inc. AbbVie Inc. did not have any influence on the conduct, results or interpretation of findings of this study. Publisher Copyright: ©
PY - 2022/11/21
Y1 - 2022/11/21
N2 - Objective To examine the effect on adherence to disease modifying anti-rheumatic drugs (DMARDs) in participants with rheumatoid arthritis (RA) of a serious game that targeted implicit attitudes toward medication. Methods A multicentre randomised controlled trial (RCT) was performed with adults with RA that used DMARDs and possessed a smartphone/tablet. Control and intervention groups received care as usual. The intervention group played the serious game at will during 3 months. Game play data and online questionnaires Compliance Questionnaire on Rheumatology (CQR), Beliefs about Medicine Questionnaire (BMQ), Health Assessment Questionnaire (HAQ) and Rheumatoid Arthritis Disease Activity Index (RADAI) were collected. Primary outcome was DMARD implementation adherence operationalised as the difference in proportion of non-adherent participants (<80% taking adherence) between intervention and control group after 3 months using a Chi-squared test. Two sample t-tests and Wilcoxon rank-sum test were performed to test for differences on secondary outcomes. Results Of the 110 intervention participants that started the study, 87 participants (79%) installed the game and had a median playtime of 9.7 hours at 3 months. Overall, 186 participants completed the study. Adherence in intervention group (63%) and control group (54%) did not differ significantly (p=0.13) at 3 months. Neither were there differences oberved in CQR continuous score, beliefs about medication (BMQ) or clinical outcomes (HAQ and RADAI). Conclusion A serious game aimed at reinterpreting attitudes toward medication failed to show an effect on adherence to DMARDs or clinical outcomes in patients with RA. The game was played frequently indicating that it can be an effective channel for reaching patients. Trial registration number NL7217.
AB - Objective To examine the effect on adherence to disease modifying anti-rheumatic drugs (DMARDs) in participants with rheumatoid arthritis (RA) of a serious game that targeted implicit attitudes toward medication. Methods A multicentre randomised controlled trial (RCT) was performed with adults with RA that used DMARDs and possessed a smartphone/tablet. Control and intervention groups received care as usual. The intervention group played the serious game at will during 3 months. Game play data and online questionnaires Compliance Questionnaire on Rheumatology (CQR), Beliefs about Medicine Questionnaire (BMQ), Health Assessment Questionnaire (HAQ) and Rheumatoid Arthritis Disease Activity Index (RADAI) were collected. Primary outcome was DMARD implementation adherence operationalised as the difference in proportion of non-adherent participants (<80% taking adherence) between intervention and control group after 3 months using a Chi-squared test. Two sample t-tests and Wilcoxon rank-sum test were performed to test for differences on secondary outcomes. Results Of the 110 intervention participants that started the study, 87 participants (79%) installed the game and had a median playtime of 9.7 hours at 3 months. Overall, 186 participants completed the study. Adherence in intervention group (63%) and control group (54%) did not differ significantly (p=0.13) at 3 months. Neither were there differences oberved in CQR continuous score, beliefs about medication (BMQ) or clinical outcomes (HAQ and RADAI). Conclusion A serious game aimed at reinterpreting attitudes toward medication failed to show an effect on adherence to DMARDs or clinical outcomes in patients with RA. The game was played frequently indicating that it can be an effective channel for reaching patients. Trial registration number NL7217.
KW - Antirheumatic Agents
KW - Health services research
KW - Rheumatoid Arthritis
UR - http://www.scopus.com/inward/record.url?scp=85142379505&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/rmdopen-2022-002616
DO - https://doi.org/10.1136/rmdopen-2022-002616
M3 - Article
C2 - 36410776
SN - 2056-5933
VL - 8
JO - RMD OPEN
JF - RMD OPEN
IS - 2
M1 - 002616
ER -