Ehrler Frederic, Gschwind Liliane, Hagberg Hamdi, Meyer Philippe, Blondon Katherine
Information Systems Directorate, University Hospital of Geneva, Geneva, Switzerland.
Department of Pharmacy, University Hospital of Geneva, Geneva, Switzerland.
JMIR Cardio. 2025 Jan 23;9:e50693. doi: 10.2196/50693.
Medication nonadherence remains a significant challenge in the management of chronic conditions, often leading to suboptimal treatment outcomes and increased health care costs. Innovative interventions that address the underlying factors contributing to nonadherence are needed. Gamified mobile apps have shown promise in promoting behavior change and engagement.
This pilot study aimed to evaluate the efficacy and usability of a gamified mobile app that used a narrative storytelling approach to enhance medication adherence among patients following acute coronary syndrome (ACS). The study aimed to assess changes in participants' beliefs about medication and self-reported adherence before and after the intervention. Additionally, user feedback regarding the narrative component of the app was gathered.
Overall, 18 patients who recently experienced ACS were recruited for a 1-month intervention using the gamified app. Participants' beliefs about medication and self-reported adherence were assessed using standardized scales pre- and postintervention. The app's usability was also evaluated through a postintervention questionnaire. Statistical analyses were performed to determine the significance of changes in belief and adherence scores.
Although 33% (6/18) of the participants did not use the intervention more than once, the remaining 12 remained engaged during the 30 days of the study. The results did not indicate a significant improvement in participants' beliefs about medication following the intervention. However, self-reported adherence significantly improved (P<.05) after the intervention with a mean score going from 29.1 (SD 6.9) to 32.4 (SD 5.6), with participants demonstrating a greater self-efficacy to their prescribed medication regimen. However, the results did not indicate a significant improvement in participants' beliefs about medication. With a mean average score of 80.6, the usability evaluation indicates a good usability rating for the gamified app. However, the narrative storytelling component of the app was not favored by the participants, as indicated by their feedback.
This pilot study suggests that a gamified mobile app using narration may effectively enhance medication self-efficacy and positively influence patients' beliefs about medication following ACS. However, the narrative component of the app did not receive favorable feedback from participants. Future research should focus on exploring alternative methods to engage participants in the app's narrative elements while maintaining the positive impact on adherence and beliefs about medication observed in this study.
药物治疗依从性差仍然是慢性病管理中的一项重大挑战，常常导致治疗效果欠佳以及医疗保健成本增加。需要有创新的干预措施来解决导致依从性差的潜在因素。游戏化移动应用程序在促进行为改变和参与方面已显示出前景。
这项试点研究旨在评估一款游戏化移动应用程序的疗效和可用性，该应用程序采用叙事性故事讲述方法来提高急性冠状动脉综合征（ACS）患者的药物治疗依从性。该研究旨在评估干预前后参与者对药物的信念以及自我报告的依从性的变化。此外，还收集了用户对应用程序叙事部分的反馈。
总共招募了18名近期经历过ACS的患者，使用这款游戏化应用程序进行为期1个月的干预。在干预前后，使用标准化量表评估参与者对药物的信念以及自我报告的依从性。还通过干预后的问卷调查对应用程序的可用性进行了评估。进行统计分析以确定信念和依从性得分变化的显著性。
尽管33%（6/18）的参与者使用该干预措施不超过一次，但其余12名参与者在研究的30天内持续参与。结果并未表明干预后参与者对药物的信念有显著改善。然而，自我报告的依从性在干预后显著提高（P<0.05），平均得分从29.1（标准差6.9）提高到32.4（标准差5.6），参与者对其规定的药物治疗方案表现出更高的自我效能感。然而，结果并未表明参与者对药物的信念有显著改善。可用性评估的平均得分为80.6，表明这款游戏化应用程序具有良好的可用性评级。然而，参与者的反馈表明，应用程序的叙事性故事讲述部分并不受青睐。
这项试点研究表明，一款使用叙事的游戏化移动应用程序可能有效地提高药物治疗自我效能感，并对ACS后患者对药物的信念产生积极影响。然而，应用程序的叙事部分未得到参与者的好评。未来的研究应侧重于探索替代方法，以使参与者参与应用程序的叙事元素，同时保持本研究中观察到的对依从性和对药物的信念的积极影响。
