Gaming Strategies Improve Treatment Adherence Among T2DM Patients

By Annette M. Boyle, contributor, and Editorial Staff

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If you have a patient with stubbornly high HbA1c, you’ve probably talked about the importance of adherence. But the truth of the matter is that taking medications is not fun and picking up prescriptions in a timely way often falls to the bottom of the day’s To Do list—leading to missed doses and gap days. Walgreens may be able to help.

In a partnership launched this fall with HealthPrize Technologies, the national pharmacy retailer will offer an online platform that uses gamification, a concept from behavioral economics that blends incentives redeemable at the drugstore with diabetes-related patient education and adherence measures. Prizes include gift cards, cookbooks, coupons and other perks.


Figure. A video game pad.
(Sources: Wikimedia Commons/By Davodd/GNU Free/Creative Commons.)

Participants are offered weekly quizzes and surveys about diabetes, fun facts and health tips, competitions and sweepstakes, scorecards for medication adherence and reminders to take daily doses as well as monthly refill notices.

In a study of the platform, 2,305 patients participated in the program. Patients received points for self-reporting injections of a diabetes medication, obtaining refills and learning about diabetes management. The average participant logged into the site 5 times per week, spending an about 2 minutes each time. More than 75% of participants completed the weekly quiz and survey and 60% of patients viewed the daily health tip.

Over an 8-month period, participants filled their prescriptions 2.9 more times than those not using the gamification platform. Mean prescription fill intervals dropped 39%, from 57.5 days prior to enrollment to 35.1 days after enrollment. By the end of the study, 96% of participants reported they would miss the program if it ended.

HealthPrize and Walgreens will roll out the gamification platform to encourage adherence to medications prescribed for other conditions that also frequently affect diabetic patients such as hypercholesterolemia in the coming months.

An earlier study of the gamification platform among 1,085 patients with high cholesterol found that the rewards, competition and engaging learning tools virtually eliminated late refills. Mean gap days—days between the end of one prescription and picking up the refill—declined from 8.81 to less than 0.06. That improved adherence from 70% to nearly 100%.