We've seen before in the Games in Medicine (Tuesdays) posts that there are some early failures in the value of gaming in health. A Cochrane Review didn't find any significant evidence that using the virtual world of Wii provided any beneficial 'arm function' or 'ADL [activities of daily living] function' in the elderly over conventional therapy. In other studies, the value of Wii gaming could easily be offset by the anti-bucolic, seasonally-affective-disorder-producing monotony of indoor activity relative to the fun of playing outdoors.
But there are obvious success also. Foldit, the addictive game of 3D spacial modeling developed at the University of Washington, found success when its crowd-sourced solution to a long-standing conundrum took only 10 days to solve. For 15 years, researchers were unable to model the correct configuration of the Mason-Pfizer retrovirus - a simian virus causing a disease similar to HIV. But within 10 days, the Foldit community was able to figure out the right answer, giving hope that similar exercises can find the right targets or compounds for faster development of antibiotics/antivirals/biologicals against difficult or neglected diseases.
In clinical medicine, we find that gaming itself can improve adherence to chemotherapy medications in adolescents. HopeLab developed an action game called Re-Mission, simulating the destruction of cancer cells by chemotherapy and the control of side effects (e.g. nausea, vomiting). Subjected to a randomized-control trial of adolescents with cancers, active participation with the game had both functional (as measured by functional-MRI) and outcome (medication adherence, self-efficacy and knowledge) improvements in the treatment wing relative to the control group.
One further cool aspect of the Foldit model that the HopeLab idea could co-opt is the team-mentality. In the Foldit world, there are scores of teams, with names like Anthropic Dream, Contenders, Void Crushers, and so forth. It would be fantastic to see Re-Mission be a multi-player game, with the participants cooperative instead of competitive. The power of crowd-sourcing added to the benefits of gamification could potentially augment the value of gaming in the Chronic Care Model.