An online game that teaches doctors and nurses blood pressure-lowering options resulted in their patients reaching a normal blood pressure faster than patients whose healthcare providers received the same information in a traditional online posting, according to research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.
Researchers found that patients of clinicians playing the game lowered their blood pressure to their target level in 142 days compared to 148 days for those who read an online posting.
"The competition proved to be a powerful incentive," said B. Price Kerfoot, M.D., Ed.M., study author and associate professor of surgery at Harvard Medical School and staff surgeon at the Veterans Affairs Boston Healthcare System.
The game used "spaced education," a technique invented by Kerfoot that Harvard is seeking to patent. Information is emailed in the form of a question, with a correct answer and explanation provided immediately after a response is submitted. The questions were emailed and adaptively reinforced for a year — hence the term "spaced education."
"Clinicians may be familiar with the guidelines, but often that knowledge isn't translated effectively into practice," Kerfoot said. "Spaced education appears to engage learners in such a way that translates evidence-based guidelines into clinician practice patterns. Testing can help with retention."
Researchers randomly assigned clinicians in eight Veterans Affairs medical centers in New England to the game or a traditional online posting with email reminders. Forty-eight clinicians completed the game and 47 read the online posting.
Those in the game competed against other participants and could see their progress as they completed tasks.
"The study shows that an easy-to-use, low-cost tool can influence doctors and benefit patients," said Alexander Turchin, M.D., M.S., a co-first-author of the study and director of informatics research in the Division of Endocrinology at Brigham and Women's Hospital in Boston, Mass. "Once you've designed the emails, you can send it to 10 people or to every single doctor in the United States without increasing your costs."
For each doctor who participated in the game, 2.3 additional patients reached normal blood pressure during the study, Kerfoot said.
"If you train one clinician you can impact many patients. There is a strong amplification effect."
Clinicians can enroll in the spaced education game for free at Qstream, a company Harvard launched to develop and disseminate the spaced education methodology outside of its firewalls.
Co-authors are Eugene Breydo, Ph.D.; David Gagnon, M.D., M.P.H., Ph.D.; and Paul R. Conlin, M.D. Author disclosures are on the manuscript.
The Research Career Development Award Program, Veterans Affairs Health Services Research & Development Service, the American Urological Association Foundation, Astellas Pharma US Inc., Wyeth Inc. and the National Institutes of Health funded the study.
For the latest heart and stroke news, follow us on Twitter: @HeartNews.
For updates and new science from Circulation follow @CircAHA.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding.
For media inquiries: (214) 706-1173
Maggie Francis: (214) 706-1382; Maggie.Francis@heart.org
Karen Astle: (214) 706-1392; Karen.Astle@heart.org
Julie Del Barto (broadcast): (214) 706-1330; Julie.DelBarto@heart.org
For public inquiries: (800) AHA-USA1 (242-8721)
heart.org and strokeassociation.org