Use of a serious game to strengthen medication adherence in euthymic patients with bipolar disorder following a psychoeducational programme: A randomized controlled trial

• Published in: Journal of affective disorders 2020-02, Vol.262, p.182-188
• Main Authors: Maurin, Kathlyne Dupuis, Girod, Chloé, Consolini, Julia Lou, Belzeaux, Raoul, Etain, Bruno, Cochet, Barbara, Leboyer, Marion, Genty, Catherine, Gamon, Lucie, Picot, Marie Christine, Courtet, Philippe, Olié, Dr Emilie
• Format: Article
• Language: English
• Subjects: Adult; Bipolar Disorder; Bipolar Disorder - psychology; Bipolar Disorder - therapy; BIPOLIFE; Computer Science; Computer Science and Game Theory; Cyclothymic Disorder; Cyclothymic Disorder - psychology; Cyclothymic Disorder - therapy; Female; Health Knowledge, Attitudes, Practice; Human health and pathology; Humans; Life Sciences; Male; Medication Adherence; Medication Adherence - psychology; Middle Aged; Patient Education as Topic; Psychiatrics and mental health; Psychoeducation; Psychosocial intervention; Serious gamel; Video Games; Video Games - psychology
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2019.10.008

•Additional tools may help to maintain medication adherence after psychoeducational programmes•BIPOLIFE® a serious game centred on an avatar teaches how to regulate mood and energy in everyday life•BIPOLIFE® improves attitudes towards medications during the first month after a psychoeducation programme Although psychoeducation programmes are the gold-standard intervention in bipolar disorder (BD), more innovative tools are needed to broaden and consolidate their effects, especially on treatment adherence. Serious games could be an option. We carried out a two-arm open randomized controlled trial to compare the add-on use of the serious game BIPOLIFE® for one month (n = 20) vs. treatment as usual (TAU; n = 21) following the completion of a psychoeducation programme in euthymic adults with BD. The primary outcome was the percentage of adherent patients (i.e., patients with a Medication Adherence Rating Scale, MARS, total score >7) at 4 months after the end of the psychoeducation programme. We also measured the changes in therapeutic adherence and beliefs on pharmacological treatments (Drug Attitude Inventory, DAI) between study inclusion and the 1-month (end of BIPOLIFE® use) and 4-month visits, healthcare use during the study period, and BIPOLIFE® acceptability. The percentage of adherent patients was lower in the BIPOLIFE® group than in the TAU group at inclusion (p = 0.02). Conversely, the absolute variation of the MARS and DAI scores was higher in the BIPOLIFE® than in the TAU group at the 1-month visit (p = 0.03 and p = 0.002, respectively) but not at the 4-month visit (p = 0.22 and p = 0.07, respectively). Small sample size, and low frequency of connexion to BIPOLIFE® declared by the patients. BIPOLIFE® may help patients with BD to increase their confidence in medications, if used regularly.