Analyzing the impact of gamification on a mHealth application for treating urinary incontinence in prostate cancer patients

Abstract

It is estimated that approximately one month after radical prostatectomy, a surgical procedure to remove the prostate, 80% of men experience urinary incontinence (UI). Behavioral therapy, which involves modifying the patient’s lifestyle habits, along with physical treatments such as exercises to strengthen the pelvic muscles and complementary behavioral therapies with techniques associated with personal beliefs, can be used to treat urinary incontinence in this context. IUProst® is a mobile health application (mHealth) designed to promote self-care and improve the quality of life for men who suffer from urinary incontinence due to prostate removal surgery caused by prostate cancer. Version 2.0 of IUProst® was released with several improvements, including adding gamification elements to encourage patient engagement in the execution of behavioral treatment exercises for urinary inconti-nence. This article presents the IUProst® application and analyzes the data generated by its use to understand the level of improvement that patients have experienced regarding urinary incontinence. It also examines the impact of gamification on exercise execution. The results demonstrate the clinical improvement in patients’ involuntary loss of urine, presenting less urine flow and reducing the feeling of urgency to go to the bathroom after using IUProst®. A comparative analysis is also included, considering the 60 days before and after the implementation of the gamification elements. During the 120 days considered, gamified data was collected for 60 days, and this period accounted for 83% of all exercises performed, despite the similar number of users using the application. The significant increase in exercise performance during the gamified period suggests that the gamification positively supported patient engagement.