Construction and application of a medication adherence management program based on TIR for patients with ischemic stroke

Jie Dong, Yayan Yi, Yimei Hu, Jinying Jiang, Guohua Zhao

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.