Gamified digital platforms as a tool for managing treatment adherence in cardiology patients

Relevance . Cardiovascular diseases remain the leading cause of morbidity and mortality, and low adherence of patients to physicians’ recommendations is one of the key problems in modern cardiology. Digital patient-centered platforms and gamification are considered a promising tool for increasing patient engagement in treatment and rehabilitation; however, the data on their effectiveness are scattered and require systematization. Objective . To conduct an analytical review and evaluate the available data on the effectiveness of digital patient-centered platforms and gamification in improving adherence to physicians’ recommendations in patients with cardiovascular diseases (coronary heart disease, chronic heart failure, arterial hypertension, including after percutaneous coronary intervention and coronary artery bypass grafting). Material and methods . The review was prepared in accordance with the PRISMA methodology. The search was performed in PubMed, Scopus, Web of Science, Cochrane, and Google Scholar for the period from 01.01.2019 to 31.03.2026. The main outcomes assessed were adherence to prescribed therapy, physical activity level, correction of risk factors, and quality of life. The risk of bias was assessed using RoB 2, ROBINS-I, and the CASP Qualitative Checklist. Of 1,254 records, 20 studies were included in the qualitative analysis after duplicate removal and screening. Results . The use of digital platforms and gamification was associated with increased adherence to cardiac rehabilitation (up to 100% in the telerehabilitation group), greater regularity of physical activity (93.8% vs 77.1% in the control group), expanded access to rehabilitation (from 21% to 63%), and improved blood pressure control, lipid profile, and quality of life. Remote programs were comparable to center-based rehabilitation in peak oxygen consumption and quality of life, and often superior in patient engagement. The long-term effect of game elements is achieved when user activity exceeds 30 days. The main barriers to implementation include low digital literacy among older patients, technical failures, unwillingness to pay for services, and insufficient integration with medical information systems. Conclusion . Digital assistants and gamified platforms are a promising addition to traditional cardiac rehabilitation. Longer studies with clinically significant endpoints (mortality, myocardial infarction) and strategies for patient retention, including further development of gamification, are needed for definitive conclusions.