A Gamified Real-time Video Observed Therapies (GRVOTS) Mobile App via the Modified Nominal Group Technique: Development and Validation Study

Abstract

Background The success rate of tuberculosis (TB) treatment in Malaysia remains below the recommended World Health Organization target of 90% despite the implementation of directly observed therapy, short-course, a physical drug monitoring system, since 1994. With increasing numbers of patients with TB in Malaysia defaulting on treatment, exploring another method to improve TB treatment adherence is vital. The use of gamification and real-time elements via video-observed therapies in mobile apps is one such method expected to induce motivation toward TB treatment adherence. Objective This study aimed to document the process of designing, developing, and validating the gamification, motivation, and real-time elements in the Gamified Real-time Video Observed Therapies (GRVOTS) mobile app. Methods The modified nominal group technique via a panel of 11 experts was used to validate the presence of the gamification and motivation elements inside the app, which were assessed based on the percentage of agreement among the experts. Results The GRVOTS mobile app, which can be used by patients, supervisors, and administrators, was successfully developed. For validation purposes, the gamification and motivation features of the app were validated as they achieved a total mean percentage of agreement of 97.95% (SD 2.51%), which was significantly higher than the minimum agreement score of 70% (P<.001). Further, each component of gamification, motivation, and technology was also rated at 70% or more. Among the gamification elements, fun received the lowest scores, possibly because the nature of serious games does not prioritize the fun element and because the perception of fun varies by personality. The least popular element in motivation was relatedness, as stigma and discrimination hinder interaction features, such as leaderboards and chats, in the mobile app. Conclusions It has been validated that the GRVOTS mobile app contains gamification and motivation elements, which are intended to encourage medication adherence to TB treatment.

Modern technologies for improving elderly patients’ compliance

“…Modern technologies allowing patients to take drugs under supervision [52,57,62], on prompts from human operators [58] or upon the advice of programmed computer systems [59][60][61] are becoming the new normal. However, with all the networked means of monitoring therapy, a new approach to maximising compliance among patients may be to merge these solutions with various technological means of influence in an attempt to maximise effectiveness through the gamification of therapy, transforming it into a positively engaging contest of sorts, where scores are kept and compared with others, while positive or negative points can be gained for fulfilling therapy-related tasks in a timely manner [103], and task-related and score-related feedback, motivation and incentives can be received [104]. Gamification-based interventions have been used with the aim of modifying habits of significance for public health, including, at first, short-term smoking abstinence [105] and then smoking cessation [106].…”

Barriers and facilitators to medication adherence in patients after PCI surgery: A mixed-methods systematic review

“…This is the direction that can be considered. Indeed, the current application of gami cation primarily focuses on enhancing motivation for engagement in interventions or behavior change [51][52][53] , without considering how gami cation could serve other behavior change drivers, such as capability and opportunity. This oversight may lead to the inability to maximize its effectiveness [15] .…”