A Team-Based Online Game Improves Blood Glucose Control in Veterans With Type 2 Diabetes: A Randomized Controlled Trial
| Autor: | Katherine E. Kurgansky, Graham T. McMahon, B. Price Kerfoot, David R. Gagnon, Jay D. Orlander, Paul R. Conlin |
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| Rok vydání: | 2017 |
| Předmět: |
Research design
Blood Glucose Male medicine.medical_specialty Glucose control Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes Electronic mail law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Diabetes mellitus Internal Medicine medicine Humans 030212 general & internal medicine Health Education Aged Veterans Advanced and Specialized Nursing Glycated Hemoglobin Internet Electronic Mail business.industry Middle Aged medicine.disease Mobile Applications Hemoglobin A Games Experimental Treatment Outcome Diabetes Mellitus Type 2 Physical therapy Health education Female business |
| Zdroj: | Diabetes care. 40(9) |
| ISSN: | 1935-5548 |
| Popis: | OBJECTIVE Rigorous evidence is lacking whether online games can improve patients’ longer-term health outcomes. We investigated whether an online team-based game delivering diabetes self-management education (DSME) to patients via e-mail or mobile application (app) can generate longer-term improvements in hemoglobin A1c (HbA1c). RESEARCH DESIGN AND METHODS Patients (n = 456) on oral diabetes medications with HbA1c ≥58 mmol/mol were randomly assigned between a DSME game (with a civics booklet) and a civics game (with a DSME booklet). The 6-month games sent two questions twice weekly via e-mail or mobile app. Participants accrued points based on performance, with scores posted on leaderboards. Winning teams and individuals received modest financial rewards. Our primary outcome measure was HbA1c change over 12 months. RESULTS DSME game patients had significantly greater HbA1c reductions over 12 months than civics game patients (−8 mmol/mol [95% CI −10 to −7] and −5 mmol/mol [95% CI −7 to −3], respectively; P = 0.048). HbA1c reductions were greater among patients with baseline HbA1c >75 mmol/mol: −16 mmol/mol [95% CI −21 to −12] and −9 mmol/mol [95% CI −14 to −5] for DSME and civics game patients, respectively; P = 0.031. CONCLUSIONS Patients with diabetes who were randomized to an online game delivering DSME demonstrated sustained and meaningful HbA1c improvements. Among patients with poorly controlled diabetes, the DSME game reduced HbA1c by a magnitude comparable to starting a new diabetes medication. Online games may be a scalable approach to improve outcomes among geographically dispersed patients with diabetes and other chronic diseases. |
| Databáze: | OpenAIRE |
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