Gamification - A Tool for Effective Patient Retention


Applied Clinical Trials

Gamification is the application of game elements and game design techniques to non-game problems.

Gamification is the application of game elements and game design techniques to non-game problems.  Nike started the whole trend with Nike+ and Pharma has followed with a high profile recent example, Syrum, from Boehringer and Kaggle.

Although there are already lots of applications for Gamification in Pharma, for me the most natural and generally untapped opportunities lie in clinical trial retention. Where we have a captive patient audience we have an opportunity to provide real value without needing to try and sell a product. What’s more, there is a real need to keep patients motivated and happy while they are on a trial to help prevent false negative reporting caused by trial fatigue.

At Langland we often get asked to create a reminder or calendar app to aid compliance and keep everyone motivated. Unfortunately, not many people really want to go to the effort of downloading an app or regularly visiting a website because they often don’t understand the benefit of doing so. This can result in the creation of an expensive tool that not many people will use and that therefore won’t deliver what is needed.

Gamification is the natural add-in as it helps build a framework around reminder/calendar functionality. However, it can be all too tempting to just bolt on a scoring matrix, rewards structure and leader board in the hope that patients will happily compete against themselves to complete their retention tasks for us. Unfortunately, such approaches are not creative and can skew results, leading many pharma companies to be rightly nervous of investing in any game-based retention programme.

When it comes to clinical trials there are a multitude of factors that influence people. Different medical conditions create different needs and wants. Merely applying a blanket-tracking tool with bolted-on gaming is not enough to cater for such widely diverse requirements. Imagine trying to get a 12-year old boy to take a peak flow reading every day for 3 years and you get an idea of the challenges faced by everyone involved.

As with everything we do the key lies in comprehensive user research to understand the specific needs of your audience and of the relevant condition. Only by understanding what people need help with in their day-to-day life (such as managing diet or exercise, or just being able to relax) can you can go about making an app, a game or website to deliver the best experience and enhance their quality of life. People are far more likely to comply if the burden of participating in a clinical trial is reduced. Once the compliance elements are in place they can then be integrated into a gaming/rewards framework within the whole retention programme.

So how do we go about creating such a bespoke idea rather than a mere gaming bolt on? I would like to share with you the six D’s framework I use as a guide when defining and evaluating Gamification ideas at Langland. This is an adapted version of the framework I learnt from Professor Werbach* on a course at the Wharton business school;

  • Define retention requirements:
    What are the critical elements of the study you are using Gamification to help with?  For example, will participants have to complete daily electronic diaries or attend study centers on a weekly basis?

  • Define desired behaviors:
    What do you want your players to do? And what are the metrics that will allow you to measure them (e.g., should the app be opened once a week, and score targets hit once a month)?

  • Describe your players:
    Where are they? How old are they? Are they male or female? What are their interests?

  • Devise your game loops: Explore in detail how you will motivate your players using engagement and progression loops. This includes how the system will get new players engaged, and how it will remain interesting for more experienced players.

  • Don't forget the fun: Would you say it was fun? Identify which aspects of the game could continue to motivate players to participate even without scores or rewards?

  • Deploy game elements: What are some of the game elements involved and what will the experience be like for the players? Describe what feedback, rewards, and other motivation the players could benefit from, and make sure these decisions are linked to your objectives.

Hopefully you will find this framework useful. As with any basic planning tool it’s no substitute for “the big idea”, but it does enable a focus on patients’ needs and on the real objectives for Gamification. I’d love to hear from anyone who has any good Gamification stories or examples - later on this year we’ll have a few Langland case studies that we will be able to share.


*Professor Werbach - For the Win: How Game Thinking Can Revolutionize Your Business -

About the author:

Mark Evans is Digital Strategy Director at Langland.  Previously working for ‘Dare’ Campaign’s digital agency of the decade and award winning digital production agency Pirata London.

Mark's portfolio contains award-winning digital projects for brands such as McLaren F1, Sony, Cadburys (Spots vs Stripes), Pepsi, Toyota, Pizza Express and Robinsons (Put on a Panto.)

Mark can be found Tweeting at @LanglandTweets and contacted by email on [email protected]


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