Impact of the Information-Motivation-Behavioral Skills Model Based Medication Literacy Intervention on Medication Self-Management Capacity in Stroke Patients: A Randomized Controlled Trial

基于信息-动机-行为技能模型的药物素养干预对中风患者药物自我管理能力的影响:一项随机对照试验

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Abstract

PURPOSE: This study aimed to evaluate the effectiveness of a multidisciplinary collaborative medication literacy intervention, grounded in the Information-Motivation-Behavioral Skills (IMB) model, on the medication self-management capacity, stroke-related knowledge, medication literacy, medication adherence, and health status of stroke patients. PATIENTS AND METHODS: This single-blind, two-arm RCT in a Wuxi tertiary hospital enrolled 127 participants, randomized into intervention (n = 63) and control groups (n = 64). The intervention group received a medication literacy intervention based on the Information-Motivation-Behavioral Skills (IMB) model through multidisciplinary collaboration, while the patients in the control group received standard care and follow-up after discharge. The primary outcome measure was medication self-management capacity, while secondary outcome measures included stroke-related knowledge, medication literacy, medication adherence, blood pressure, lipid levels, and unplanned readmission rates. The generalized estimating equation (GEE) model was employed to assess the effectiveness of the intervention. RESULTS: Compared with the control group, the intervention group showed significant improvement in medication self-management capacity (β(day of discharge) = 1.41, p = 0.045, Cohen's d = 0.31; β(4) weeks = 2.74, p = 0.003, Cohen's d = 0.52; β(12) weeks = 3.46, p = 0.003, Cohen's d = 0.74). Significant improvements were also observed in stroke-related knowledge (β(4) weeks = 2.67, p < 0.001; β(12) weeks = 3.97, p < 0.001), medication literacy (β(4) weeks = 1.22, p < 0.001; β(12) weeks = 1.18, p < 0.001), medication compliance (β(4) weeks = 1.07, p = 0.034; β(12) weeks = 1.45, p = 0.013), and blood pressure reduction (p < 0.05). The intervention did not significantly affect blood lipids or unplanned readmission rates (p > 0.05). The sensitivity analysis using the PP method indicated that the obtained results were comparable to the ITT results, suggesting that the preliminary research results and conclusions of the medication literacy intervention based on multidisciplinary collaboration were reliable. CONCLUSION: The medication literacy intervention based on the Information-Motivation-Behavioral Skills (IMB) model effectively enhances the medication self-management capacity of stroke patients. It positively influences several outcomes, including stroke-related knowledge, medication literacy, medication adherence, blood pressure.

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