| Objective:1.To identify the factors affecting the adherence of sublingual immunotherapy in patients with allergic rhinitis and to provide support and guidance for improving the adherence of patients with allergic rhinitis.2.To evaluate the effect of intervention based on information-motivation-behavior skill（IMB）model on sublingual immunotherapy adherence,medication belief,self-efficacy and medication knowledge in patients with allergic rhinitis.Methods:1.Meta analysis:Cochrane Library,Pub Med,Web of Science,Embase,CNKI,Wanfang database,VIP database and CBM database were searched until 1 April 2020.The articles about the influencing factors of sublingual immunotherapy adherence of patients with allergic rhinitis.The influencing factors were analyzed by Rev Man5.3.The odds ratio（OR）and standarized mean difference（SMD）were used to measure the classification index and continuous index respectively.2.Quasi-experiment:a total of 120 patients with allergic rhinitis in Otorhinolaryngology clinic were divided into control group（n=60）and experimental group（n=60）from August 2020 to March 2021.The control group received routine intervention,the experimental group received intervention based on IMB model.The Medication adherence,medication belief,self-efficacy and medication knowledge level of the two groups were evaluated before intervention,immediately,1 month and 3 months after intervention.Results:1.Meta-analysis finally included 10 articles,and analyzed 7 indicators in total,including:patient age,medication inconvenience,improvement of conscious symptoms,poor conscious treatment effect,adverse reactions,economic status,and education level.This study shows that 6 influencing factors are statistically associated with sublingual immunotherapy adherence.They are the poor self-conscious treatment effect:OR=0.37,95%CI:0.21～0.64,PQ=0.0008,P=0.42;self-conscious symptoms improved:OR=0.37,95%CI:1.10～8.38,PQ<0.00001,P=0.03;Economic situation:OR=5.27,95%CI:1.49-18.58,PQ<0.00001,P=0.010;Adverse reaction:OR=6.45,95%CI:2.59～16.08,PQ<0.00001,P<0.00001;inconvenience of medication:OR=4.00,95%CI:2.04～7.85,PQ<0.00001,P<0.0001;education level:OR=1.89,95%CI:1.22～2.94,PQ=0.14,P=0.005.2.The scores of compliance,belief,self-efficacy and knowledge of medication in the experimental group were significantly higher than those in the control group immediately after intervention,one month after intervention and three months after intervention,and there was significant difference between the two groups（P<0.05）.The results of MANOVA Of Repeated Measuring showed that medication adherence:Ftime=57.34,P<0.05,Fintervention=188.63,P<0.05,Finteraction=182.61,P<0.05;Medication belief:Ftime=216.77,P<0.05,Fintervention=178.90,P<0.05,Finteraction=223.00,P<0.05;Self-efficacy:Ftime=17.10,P<0.05,Fintervention=88.99,P<0.05,Finteraction=85.47,P<0.05;knowledge level of medication:Ftime=483.32,P<0.05,Fintervention=496.04,P<0.05,Finteraction=273.13,P<0.05.The results showed that the intervention was effective,and the scores of the four outcome indexes of the two groups varied with time,and the change of the test group was better than that of the control group.Conclusion:1.The main influencing factors of the adherence of SLIT in patients with AR are:medication inconvenience,conscious improvement of symptoms,poor conscious treatment effect,adverse reactions,economic situation and education level.Medical staff should construct a reasonable management plan based on influencing factors,such as strengthening health education about patients’diseases and medications,and formulating reasonable follow-up plans to enhance patient adherence and ensure the efficacy of sublingual immunotherapy.2.Implementing interventions based on the IMB model for people who use sublingual immunotherapy for allergic rhinitis can effectively improve patients’medication belief,self-efficacy and knowledge of medication,thereby improving their medication adherence,ensuring efficacy,and providing medication care for outpatients Provided for reference. |
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