Increasing patient engagement in your clinical trials: How Gamification makes a difference

Patient retention in clinical trials has long been a significant challenge faced by sites, sponsors, and CROs. A recent report1Decentralized clinical trials: Are we ready to make the leap? by Biopharma Dive highlights that 85% of clinical trials fail to recruit enough patients, with 80% experiencing delays due to recruitment issues. Additionally, high dropout rates persist as sites struggle to keep enrolled patients engaged throughout the study.

What is gamification in clinical trials?

Gamification is a technique that can be used in systems such as ePROs to create similar experiences to those we have while playing a game in order to motivate users and keep them engaged.

In the course of a clinical trial, patients are tasked with answering extensive questionnaires and completing diaries on a daily basis, a dreary task although crucial to gather data regarding patient’s not only quality of life but also safety. And this is where gamification is a game changer.

“Introducing gamification with Trial Online has improved the satisfaction of our patients and therefore increased the robustness of the data base.” 

Diego Herrera Egea, Senior Leader, Clinical Data & Information Management, Almirall

Why is gamification crucial for a better patient engagement?

The power of gamification lies in its ability to tap into fundamental human desires for achievement, creativity, recognition, and social interaction. Here are the key drivers behind gamification’s effectiveness:

  1. Engagement and Motivation: Capture attention and keeps individuals engaged through challenges, rewards, and progress tracking.
  2. Sense of Purpose: Connect participants to a larger cause, providing a sense of meaning and significance.
  3. Social Interaction: Foster collaboration and interaction among participants, creating a sense of community.
  4. Personalization and Empowerment: Allow individuals to personalize their experience and make meaningful choices.
  5. Feedback and Progress Tracking: Provide immediate feedback on performance, promoting a sense of accomplishment.
  6. Overcoming Challenges and Curiosity: Incorporate elements of unpredictability and curiosity, keeping participants engaged.
  7. Emotional Connection and Enjoyment: Evoke positive emotions, making tasks more enjoyable and immersive.

How we incorporate gamification in Trial Online systems?

At Trial Online, our ePRO system is designed to incorporate gamification elements, making the patient’s journey in a clinical trial more exciting and engaging. Through the ePRO app, users can track their activity and study progress, receive guiding or encouraging notifications and alerts for pending tasks, and earn badges and prizes upon completing questionnaires or eDiaries. Communication is streamlined and tailored to each patient’s needs.

What are the results of incorporating gamification?

By incorporating gamification, we have observed significant improvements in patient retention and data quality. Patients remain in the trial for longer durations, complete questionnaires and eDiaries more accurately and on time, and ultimately contribute to excellent data collection.

Looking closely at one of our studies, a phase III actinic keratosis study involving 105 patients across 20 US sites, where diary completion was required, the results of incorporating gamification elements into our Trial Online ePRO platform speak for themselves.


of patients completed
the study


of total patient visits (622 visits) were completed


of patients installed
the ePRO app


diary completion between eDiary and paper version

About the author:

Picture of Maria Milas

Maria Milas

Certified clinical research professional (CCRA) helping drive innovation and change in clinical research. Passionate about collaborating with the product management team in developing technology tools that reshape healthcare but also about crafting and disseminating thought leadership content that represents our commitment to innovation.

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