Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial
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 R...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/8/2/e002616.full |
| _version_ | 1811189172034076672 |
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| author | Sandra van Dulmen Johanna E Vriezekolk Bart van den Bemt Harald E Vonkeman Renske CF Hebing Bart P H Pouls Charlotte L Bekker Fatma Gundogan Hein AW van Onzenoort Liesbeth I van de Ven Rob Tieben |
| author_facet | Sandra van Dulmen Johanna E Vriezekolk Bart van den Bemt Harald E Vonkeman Renske CF Hebing Bart P H Pouls Charlotte L Bekker Fatma Gundogan Hein AW van Onzenoort Liesbeth I van de Ven Rob Tieben |
| author_sort | Sandra van Dulmen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T14:30:26Z |
| format | Article |
| id | doaj.art-f810a76e7f784bb593b4ae78dbdf0cfb |
| institution | Directory Open Access Journal |
| issn | 2056-5933 |
| language | English |
| last_indexed | 2024-04-11T14:30:26Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj.art-f810a76e7f784bb593b4ae78dbdf0cfb2022-12-22T04:18:39ZengBMJ Publishing GroupRMD Open2056-59332022-11-018210.1136/rmdopen-2022-002616Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trialSandra van Dulmen0Johanna E Vriezekolk1Bart van den Bemt2Harald E Vonkeman3Renske CF Hebing4Bart P H Pouls5Charlotte L Bekker6Fatma Gundogan7Hein AW van Onzenoort8Liesbeth I van de Ven9Rob Tieben10Netherlands Institute for Health Services Research, NIVEL, Utrecht, The NetherlandsRheumatology, Sint Maartenskliniek, Nijmegen, the NetherlandsPharmacy, Sint Maartenskliniek Afdeling Reumatologie, Nijmegen, The NetherlandsDepartment of Rheumatology & Clinical Immunology, Medisch Spectrum Twente, Enschede, The NetherlandsRheumatology, Pharmacy, Reade Hoofdlocatie Dr Jan van Breemenstraat, Amsterdam, The Netherlands1 Research & Innovation, Sint Maartenskliniek, Ubbergen, Gelderland, The Netherlands2 Department of Pharmacy Radboudumc, Radboud Institute for Health Sciences, Nijmegen, Gelderland, The Netherlands3 Pharmacy, Gelre Ziekenhuizen Apeldoorn, Apeldoorn, Gelderland, The Netherlands2 Department of Pharmacy Radboudumc, Radboud Institute for Health Sciences, Nijmegen, Gelderland, The Netherlands6 Pharmacy, Maastricht UMC+, Maastricht, Limburg, The Netherlands9 Research, Development and Innovation, Game Solutions Lab, Eindhoven, The NetherlandsObjective 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.https://rmdopen.bmj.com/content/8/2/e002616.full |
| spellingShingle | Sandra van Dulmen Johanna E Vriezekolk Bart van den Bemt Harald E Vonkeman Renske CF Hebing Bart P H Pouls Charlotte L Bekker Fatma Gundogan Hein AW van Onzenoort Liesbeth I van de Ven Rob Tieben Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial RMD Open |
| title | Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial |
| title_full | Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial |
| title_fullStr | Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial |
| title_full_unstemmed | Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial |
| title_short | Gaming for Adherence to Medication using Ehealth in Rheumatoid arthritis (GAMER) study: a randomised controlled trial |
| title_sort | gaming for adherence to medication using ehealth in rheumatoid arthritis gamer study a randomised controlled trial |
| url | https://rmdopen.bmj.com/content/8/2/e002616.full |
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