I’ve always been someone who (pretty much) does what I’m told. When my parents or a doctor told me “Take your medicine”, I complied. However, I remember a number of years ago when I was taking an antibiotic for a bad kidney infection; I started to feel better and I wondered why I should continue to take the drug. It wasn’t until someone explained to me that by not taking all the medication, or even skipping a few pills, the bacteria-causing infection could become resistant to future antibiotic treatment – they’d be bigger, “badder”, bacteria. This tidbit of information made perfect sense to me and I’m pleased to report that today, I take all my medications as prescribed, even when I might not have any symptoms.

Based on my personal experiences, I was very surprised to learn what an extreme problem drug adherence is to the health care system. It appears that many, many people are not listening to their health care professionals about taking their medicine as they should.

Before looking at possible solutions to this national epidemic, let’s identify a few reasons patients don’t take, or sometimes, even fill, their prescriptions. One common reason is a lack of understanding about the disease or diagnosis for which the prescription was written. Other reasons may be concerns about the drug’s effectiveness, fears related to medical side-effects, lack of belief that they can control the disease, or like me with the antibiotic, they stop taking the medication because they are feeling better and don’t realize the side effects of not taking all of the prescription. It seems to me that many of these reasons for non-adherence can be addressed if people were provided with more information about both their medical conditions and how their medications can be of benefit.

One possible emerging solution to this information/education problem is the application of healthy games – multimedia experiences that are fun and deliver health benefits. Healthy games hold the potential for many benefits, including improving health literacy, physical fitness, cognitive fitness, condition management and motivating behavior change (like increasing the likelihood of drug adherence).

iConecto, a company working to empower personal health and organizational performance though healthy games, gaming technologies and social media, has collected the largest database of healthy games for consumers and professionals. In addition, iConecto is tracking the evidence and experience of the benefits of these games. Currently, there are over 35 documented studies which show that well-designed games can help engage and empower consumers health behaviors leading to higher treatment regime adherence, better overall health, and more clarity in communication with others about their conditions. These clinical studies have focused on a variety of areas, including cancer, asthma, diabetes, cystic fibrosis, exercise/weight loss and brain games. This blog post will focus on a few examples related to improving drug adherence through the use of healthy games.

One of the more well-known healthy games is “Re-Mission“, developed by Hope Labs, a first-person shooter game where players shoot and kill cancer cells while learning about the efficacy of different forms of treatment. According to an August 2008 article in the journal Pediatrics, results from a randomized, controlled study found that playing Re-Mission improved adolescent and young adult cancer patients’ cancer-related knowledge, self-efficacy and adherence to their prescribed cancer treatment plan. In a “Re-Mission” study conducted by the University Medical Center Utrecht in the Netherlands, one group of cancer patient played “Re-Mission” while the other (control) group played “Indiana Jones and the Emperor’s Tomb” – a strictly entertainment game with a similar design and interface to “Re-Mission”. This study, which included 375 male and female cancer patients aged 13 – 29, showed that those patients playing “Re-Mission” had higher drug adherence to both antibiotics and standard chemotherapy drugs. The assumption made in the study is that by playing “Re-mission”, the patients learned more about their disease and how they could control it through medication and chemotherapy.

Similarly, two asthma-related multi-media games have demonstrated increased knowledge of asthma and decreased asthma symptom days (perhaps from better adherence to daily doses of inhaled corticosteroids). Games designed around diabetes (Packy and Marlon, Escape from Diab and Nanoswarm) have shown, or are in clinical trials to show, improved self-efficacy and self-management. In the Packy and Marlon study, the treatment group who played this game had a 77-percent decrease in diabetes and emergency and urgent care clinical visits. Another approach to gaming for kids with diabetes is Bayer’s Didget, and its precursor Glucoboy. These are two blood glucose meters designed for kids with diabetes. They interface with the Nintendo DS and reward children with diabetes if they measure and track their blood sugar levels. Blood sugar levels in the correct range will unlock fun games on the Nintendo DS. Initial evidence has shown that kids with diabetes are much more likely to measure their blood glucose levels with this innovative meter. Didget also connects users to an online community to add the benefits of social networking to good health behavior motivation. Bayer’s Didget is not yet available in the U.S. but more information is available on www.bayerdidget.com.

If we consider exercise a health prescription (and there are plenty of people not adhering to that prescription), there are many examples of exergames, like the Wii Fit and Dance, Dance, Revolution, that have shown when exercise is made “fun”, people show a greater physical exertion rate and greater long, term exercise program adherence. Games have also been shown to improve overall healthy behaviors – for instance improving eating habits, enabling smoking cessation and reducing stress.

Finally, when it comes to medication, you may have heard that “Laughter is the best medicine!” and I agree wholeheartedly that having fun is key to our physical, mental and emotional well being. It serves to reason then, that since games are fun, engaging and educational – they can be a great approach to help us adhere to the best medicine of all.

This entry was posted on Wednesday, November 4th, 2009 at 6:28 am and is filed under Drug Adherence, HIT/Health Gaming. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.