Impact of Nurse-Led Psychoeducation Using Gamification Tools on Medication Adherence in Patients with Bipolar Disorder

Abstract

Medication non-adherence remains a critical challenge in the management of bipolar disorder, often resulting in symptom relapse, hospital readmissions, and poor quality of life. Traditional psychoeducation, while effective, may lack engagement and retention, particularly in psychiatric populations. Integrating gamification using game-like elements to enhance motivation into nurse-led psychoeducation offers a promising, underexplored approach. This study aimed to evaluate the effectiveness of a nurse-led psychoeducational program incorporating gamification tools on improving medication adherence among patients with bipolar disorder at Saidu Group of Teaching Hospitals (SGTH). A quasi-experimental design with a non-equivalent control group was employed. Sixty patients with bipolar disorder were purposively assigned to intervention (n=30) and control (n=30) groups. The intervention group received four weekly gamified psychoeducation sessions delivered by psychiatric nurses, while the control group received standard psychoeducation. Medication adherence was measured pre- and post-intervention using the Medication Adherence Rating Scale (MARS). Data were analyzed using SPSS v27 with paired and independent t-tests. The intervention group showed a significant increase in adherence scores post-intervention (mean difference = +2.93, p < 0.001), while the control group showed no significant change (p = 0.081). Between-group comparison also showed a statistically significant difference (p < 0.001). Participant feedback indicated high satisfaction and engagement with the gamified content. Gamification-enhanced, nurse-led psychoeducation significantly improves medication adherence in bipolar disorder patients. This innovative, low-cost approach should be considered in psychiatric nursing practice to enhance patient outcomes.