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Web-based interventions including social support groups and gamification can help rheumatoid arthritis (RA) patients, according to research published in the Journal of Medical Internet Research in January.

Researchers from the University of Lugano in Switzerland explored 5 prongs of web based interventions in order to observe the effects on RA patients. The interventions included online social support features and gamification – application of game design principles to non game related tasks and functions, used to improve user engagement and self contribution – on physical activity, health care utilization, medication overuse, empowerment, and RA knowledge of the patients. A total of 155 patients were included in the study and were recruited into 1 of 4 experimental conditions. Data was collected through identical questionnaires at baseline, at 2 months post test, and after an additional 2 months of follow up.


Physical activity was defined by stretching or strengthening exercises, walking, swimming or aquatic exercises, bicycling, and other aerobic exercise equipment use. This exercise was scored per week on a scale from 0 (never) to 5 (more than 3 hours per week). Health care utilizations were based on self reported visits to physicians, the emergency room, to chiropractors, physical therapy, and nights in the hospital. Medication overuse of prescription drugs was measured using yes or no questions, where 1 equaled yes and 0 signified no. The sum of the final score was mapped on a range from 0 to 100, and the higher the number, the greater the misuse of medication. RA knowledge was demonstrated using a Patient Knowledge Questionnaire, using the final score of 15. Empowerment was measured on a scale adapted for RA patients. Subdimensions of the scale, which included 12 items, incorporated topics like meaning, competence, self determination, and impact.

Over time, physical activity increased over time for patients with access to social support plus gamification/ engagement tools. However, healthcare service utilization decreased in patient groups who used social support features and gaming.

Empowerment levels changed over time, the researchers found, and more so in groups which had access to social online support groups or a gamified experience of the website used in the demonstration. This result challenges and contrasts with an earlier study done with a similar website used, and it found no effect on empowerment. None of the experimental conditions had any effect on RA knowledge in the patient groups, which was in line with the prior study the authors referenced.

“This study pointed to the positive potential and the promising desirable effects of online social support and especially gamification on patients’ behavioral and health outcomes when included in an eHealth intervention,” the authors concluded.