HealthDay News — An online spaced-education (SE) game among clinicians can improve their patients’ time to blood pressure (BP) target, according to a study published in the May issue of Circulation: Cardiovascular Quality and Outcomes.

B. Price Kerfoot, MD, EdM, from the Veterans Affairs Boston Healthcare System, and colleagues examined whether an online SE game given to primary care practitioners could reduce the time to BP target among their patients with hypertension.

A total of 111 primary care clinicians at eight hospitals were randomly assigned to two groups in a 52-week trial: SE clinicians were enrolled in a game, while control physicians received identical educational content in an online posting.

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SE game clinicians were emailed one question every three days, and questions answered incorrectly or correctly were resent in 12 or 24 days, respectively. A question was retired when answered correctly on two consecutive occasions.

Eighty-seven percent of clinicians completed the game, while 84% of control physicians read the online postings. In multivariable analysis, the researchers found that of 17,866 hypertensive periods for 14,336 patients, in the SE game cohort the hazard ratio for time to BP target was 1.043 (P=0.018).

To normalize one additional patient’s BP, 67.8 hypertensive episodes were needed, and to achieve this the number of clinicians needed to teach was 0.43.

“An online SE game among clinicians generated a modest but significant reduction in the time to BP target among their hypertensive patients,” the researchers wrote.

One author disclosed financial ties to Qstream, an online platform launched to host spaced education outside the firewalls of Harvard University.


  1. Kerfoot BP et al. Circ Cardiovasc Qual Outcomes. 2014; 7: 468-474.