Identified gamification opportunities for digital patient journey solution during an arthroplasty journey: secondary analysis of patients' interviews.

AIM: The use of gameful design for supporting health-related behaviours has been one of the major trends in health technology. An opportunity to increase engagement and motivation in a given health behaviour and the possibility of reaching improved outcomes through continued or consistent behaviour could be provided by gamification. This study aimed to identify gamification opportunities for digital patient journey solutions to increase patients' engagement and motivation for health-related behaviour during an arthroplasty journey. DESIGN: A secondary analysis. METHOD: Semistructured interviews were performed among 20 elective primary total hip and knee arthroplasty patients in a single joint-replacement centre in Finland during autumn 2018. NVivo software was used for deductive content analysis. The study was conducted among 20 patients in a single joint replacement centre during 2018. RESULTS: Several opportunities for gamification were identified for digital patient journey solutions, which could be used in advanced care to increase patients' engagement and motivation for health-related behaviour during the arthroplasty journey. These opportunities were identified related to five dimensions: accomplishment, challenge, guided, playfulness and social experience. Clear, scheduled, progressive and personalized goals with an activity tracking, real-time timespan visualization and social networking with peers, support networks and healthcare providers could be provided. Opportunities for competition and immersion were not identified.

Enzyme-assisted synthesis and structure characterization of glucuronic acid conjugates of losartan, candesartan, and zolarsartan.

Three angiotensin II receptor antagonists--losartan, candesartan, and zolarsartan--were investigated. All the compounds, which are structural analogues, are metabolized via conjugation to glucuronic acid. Interestingly, both O- and N-glucuronidation take place, so that regioisomers are formed. One ether O-glucuronide, two acyl O-glucuronides, and five tetrazole-N-glucuronides were biosynthesized, in milligram scale, from the three sartan aglycones. Liver microsomes from bovine, moose, rat, and pig and recombinant human UDP-glucuronosyltransferases were used as catalysts. The synthesized compounds were identified as sartan glucuronides by mass spectrometry, while the sites of glucuronidation were determined by nuclear magnetic resonance spectroscopy. Drug metabolites are needed as standards for pharmaceutical research and, as the present study shows, they can easily be produced with enzymes as catalyst.