An online game that teaches doctors and nurses blood pressure-lowering options resulted in their patients reaching a normal blood pressure faster than patients whose healthcare providers received the same information in a traditional online posting, according to a new study.

Researchers found that patients of clinicians playing the game lowered their blood pressure to target levels in 142 days, six days faster than those whose providers got information online.

“The competition proved to be a powerful incentive,” said B. Price Kerfoot, M.D., Ed.M., study author and associate professor of surgery at Harvard Medical School and staff surgeon at the Veterans Affairs Boston Healthcare System in Massachusetts.

Doctors and nurses playing the game received emails every three days with questions, entered answers, then immediately received the correct answers and explanations. Future emails were adapted to their responses and sent regularly for a year. Blood-pressure gamers could see how their performance compared to others. The game used a technique Kerfoot developed called “spaced education,” which Harvard plans to patent.

“Clinicians may be familiar with the guidelines, but often that knowledge isn’t translated effectively into practice,” Kerfoot said. “Spaced education appears to engage learners in such a way that translates evidence-based guidelines into clinician practice patterns. Testing can help with retention.”

Forty-eight healthcare providers in eight Veterans Affairs medical centers finished the game and 47 read online postings.

“The study shows that an easy-to-use, low-cost tool can influence doctors and benefit patients,” said Alexander Turchin, M.D., M.S., a co-first-author of the study and director of informatics research in the Division of Endocrinology at Brigham and Women’s Hospital in Boston, Massachusetts.

“Once you’ve designed the emails, you can send it to 10 people or to every single doctor in the United States without increasing your costs.” For every doctor who participated in the game, 2.3 more patients reached normal blood pressure during the study, Kerfoot said. “If you train one clinician you can impact many patients. There is a strong amplification effect.”

Clinicians can enroll in the spaced education game for free at Qstream, a company launched by Harvard. The study was published in the American Heart Association’s journal Circulation: Quality and Outcomes.