Researchers Rodrigo de Oliveira, Mauro Cherubini, and Nuria Oliver, at Telefonica, in Spain, developed a mobile phone app that tries to make it more engaging to try to take your medications on time. They tested it with 18 elders. It worked!
Each participant used two versions of the app, for three weeks each. The control version just provided a big button for the user to press when they took a pill. The social game version also provided a public leaderboard. You scored +2 points for taking the medicine within 15 minutes of when you were supposed to, +1 for taking it 15-30 minutes early or late. Game points were recorded based on self-report, but trial outcomes were measured using a special pill bottle that recorded timestamps of when it was opened.
The median time shift from desired medication time was 240 seconds (4 min) in the game condition, 420 seconds (7 min) in the control condition. The difference in means was larger, due to outliers in the control condition taking a very long time. That may be explained, at least in part, however, by the inclusion of a reminder, in the game condition only, if the med had not been recorded 15 minutes after the target time. But since 90% of the time people took their meds before the 15 minute reminder, that doesn’t explain the difference in medians.
Interestingly, many of the participants said beforehand they weren’t interested in a game as a reward system (7 of the 18 ranked it last among five possible motivators), but even so it seemed to be effective.
One caveat is that the participants were all quite good at taking their medications. They almost never missed a dose, in either condition, and even in the control condition the median time offset was only 7 minutes. This is not typical of what has been reported in prior literature. The question, then, is whether the game only works to improve adherence for people whose adherence is already good enough, or whether it would also work for people who frequently miss doses or take them very late.
It’s also not clear which aspects of the game made it engaging. It would be nice to have a follow-up trial that compares an individual score-keeping system with the social comparison version that was tested, which included score-keeping and a leaderboard.
Healthier Together 
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