{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:09:52Z","timestamp":1788952192516,"version":"build-2803163510"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain is a leading cause of disability. Existing evidence on digital gamification remains mixed. This systematic review aims to explore the use of gamification in chronic pain interventions for adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of randomized controlled trials using digital gamification pain intervention for adults with chronic non-cancer pain was included. Data on gamification mechanisms, pain intensity, and user-related outcomes were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 17 randomized controlled trials with 768 participants were included. The most common elements of gamification were feedback, challenges, and rewards. Twelve studies reported significant pain reduction, with virtual reality and sensor-based games showing immediate effects. Feedback and challenge-based designs were associated with improved pain outcomes and user engagement. However, adherence and long-term efficacy varied, and some studies reported adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gamification, particularly virtual reality and feedback-driven interventions, shows promise in reducing chronic pain and enhancing motivation. However, heterogeneity in design, limited long-term data, and risk of bias highlight the need for interventions evaluated in high-quality randomized controlled trials with longer follow-up periods. Future research should explore personalized gamification strategies and underlying mechanisms to optimize chronic pain management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/fampra\/cmag069","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:34:40Z","timestamp":1788521680000},"source":"Crossref","is-referenced-by-count":0,"title":["Digital gamification in chronic pain management in adulthood: a systematic review"],"prefix":"10.1093","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0815-5783","authenticated-orcid":false,"given":"Jiafan","family":"He","sequence":"first","affiliation":[{"name":"School of Nursing and Health Sciences, Hong Kong Metropolitan University , Kowloon, Hong Kong 999077 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyrone Tai On","family":"Kwok","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Sciences, Hong Kong Metropolitan University , Kowloon, Hong Kong 999077 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi Mun Yee","family":"Tse","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Sciences, Hong Kong Metropolitan University , Kowloon, Hong Kong 999077 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukki Suk Ki","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Nursing, Hong Kong Polytechnic University , Kowloon, Hong Kong 999077 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanqin","family":"Hu","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Sciences, Hong Kong Metropolitan University , Kowloon, Hong Kong 999077 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziji","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Sciences, Hong 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