The Impact of Gamified Interventions on the Management of Chronic Obstructive Pulmonary Disease: Systematic Literature Review.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) requires consistent sustained management, including regular physical activity, pulmonary rehabilitation, and self-care adherence. Despite strong clinical guidelines, patient engagement remains a major challenge, leading to suboptimal disease control and increased health care use. Gamified interventions have emerged as potential tools to improve adherence, motivation, and outcomes in chronic disease management. However, their effectiveness and implementation in COPD remain underexplored.

Objective: This review synthesizes current evidence on gamified interventions for COPD management to evaluate their effectiveness, focusing on patient engagement, physical outcomes, and quality of life.

Methods: We conducted a systematic search in PubMed, Scopus, Web of Science, Embase, IEEE Xplore, Cochrane Library, and China National Knowledge Infrastructure for studies published from January 2014 to October 2024. Only original studies involving trials (both randomized controlled trials [RCTs] and non-RCTs), intervention studies, feasibility studies, cross-sectional surveys, or qualitative studies were included.

Results: A total of 29 studies met the inclusion criteria: 11 (38%) RCTs; 7 (24%) pilot studies; 5 (17%) observational studies (including qualitative studies); and 6 (21%) other studies using gamified technologies such as virtual reality, exergames, and mobile apps. Compared to nongamified methods, gamified interventions provided an engaging, home-based alternative for COPD management, supporting long-term rehabilitation. Gamification features such as real-time feedback, adaptive challenges, and personalized goals increased patient adherence and motivation, with high engagement seen in virtual reality and exergame-based interventions, and showed notable improvements in COPD management, enhancing exercise tolerance, self-management, and symptom control. However, most of the studies (22/29, 76%) were of short duration, with small sample sizes.

Conclusions: Gamified COPD management tools offer flexibility and empower patients to self-manage their condition, potentially reducing the need for clinic visits. Gamified interventions show promise in COPD management, although current studies have methodological limitations. Future research should focus on conducting larger trials to assess the sustained impact of gamified interventions on COPD outcomes; developing culturally relevant adaptations to enhance the global applicability of these interventions; and collaborating with patients, clinicians, and game developers to make the interventions more engaging and effective.