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Construction and application of a medication adherence management program based on TIR for patients with ischemic
Jie Dong1, Yayan Yi1, Yimei Hu1
1Department of Nursing, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Objective:
This study aimed to construct a multidisciplinary medication management program based on the Timing It Right Theory (TIR) and evaluate its effects on medication adherence, medication beliefs, and medication knowledge in patients with ischemic stroke.
Methods:
A total of 143 patients with ischemic stroke from a tertiary hospital in Zhejiang from January to October 2024 were enrolled in the study. To avoid cross-contamination, patients were assigned to an intervention group (n = 70) and a control group (n = 73) based on their hospital floor. The research team systematically searched relevant Chinese and English databases and developed a TIR-based Medication Management Program for patients with ischemic stroke. The control group received routine medication guidance and discharge education. In addition to routine care, the intervention group received TIR-based medication management from admission to 3 months after discharge. Medication knowledge was assessed using Medication Knowledge Questionnaire at baseline and discharge. Medication adherence and medication beliefs were assessed using the 8-item Morisky Medication Adherence Scale and the Beliefs about Medicines Questionnaire-Specific at baseline, discharge, and 1 and 3 months after discharge. The trends and differences between the two groups were analyzed.
Results:
Non-significant differences were found in baseline scores of medication knowledge, medication adherence, or medication beliefs between the two groups (p > 0.05). At discharge, the medication knowledge score in the intervention group (38.21 ± 6.02) was significantly higher compared to that in the control group (34.62 ± 4.98) (p < 0.05). Repeated measures analysis of variance demonstrated significant differences in medication adherence and medication belief scores between the two groups at discharge, 1 month after discharge, and 3 months after discharge (p < 0.05). Medication adherence scores in the intervention group were higher than those in the control group at all follow-up time points. In the Beliefs about Medicines Questionnaire, the intervention group had higher necessity scores and lower concerns scores than the control group, and the differences were statistically significant (p < 0.05).
Conclusion:
The multidisciplinary medication management program assigned to TIR can effectively improve medication knowledge, optimize medication beliefs, and enhance medication adherence in patients with ischemic stroke.
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