All in the game? Gamification and behaviour change in the self-management of chronic illness

Abstract

Background: The notion of gamification is gaining traction in healthcare, and we are seeing a proliferation of gamification applications purporting to improve health and wellbeing. The majority of these applications are commercial in orientation, do not explicitly cite behaviour theory in their development, and are marketed to general consumer populations. This review seeks to identify the characteristics and effectiveness of gamification applications designed for patients living with chronic illness. Methods: A PubMed electronic database review conducted in February 2017 sought to identify gamification applications designed to support patients living with a chronic illness. A total of 131 papers were identified, of which 10 reported on the design and/or effectiveness of gamification applications in adults living with chronic illness. Findings: The gamification applications considered in the resultant papers were developed for specific patient populations (e.g., hypertension, stroke, thalassemia) and included a range of gamification formats (e.g., web-based, smartphone app, serious video games, motion controlled games) and features (e.g., tracking, personalized avatars, making pledges, completing quests). While feasibility and development studies indicate promise, studies definitively demonstrating positive behavioral and health outcomes are limited. Discussion: Research demonstrating the efficacy of gamification applications in chronic illness is in its infancy. Use of behavior change theory in the design of gamification applications in chronic illness may support more coherent game design and user experience, as well as improve the efficacy of applications. Health psychology thus has a clear role in supporting the design and evaluation of gamification applications.