Development and evaluation of a formula for predicting introduction of medication self-management in stroke patients in the Kaifukuki rehabilitation ward

Abstract

BackgroundMedication self-management in stroke patients is important to prevent further progression of disease and incidence of side effects. The purpose of this study was to create a formula for predicting medication self-management introduction in stroke patients using functional independence measure items and patient data, including medication-related information.MethodsThis was a retrospective analysis of 104 patients (cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage) discharged from the Kaifukuki rehabilitation ward at Showa University Fujigaoka Rehabilitation Hospital from January to December 2012. Multivariate analysis was performed to develop a formula for predicting achievement of medication self-management.ResultsOf the 104 patients, 39 (37.5%) achieved medication self-management. In the logistic regression analysis, number of drugs, age, walk/wheelchair mobility FIM, and memory FIM were extracted as significant factors independently contributing to achievement of medication self-management (p < 0.05). The prediction formula was [4.404 − 0.229 × number of drugs at admission + 0.470 × walk/wheelchair mobility FIM at admission + 0.416 × memory FIM at admission − 0.112 × age].ConclusionsIn the future, this formula may be used as an index to predict success of medication self-management in stroke patients.

Pharmacist medication instructions are associated with continued medication self-management in older adults: a retrospective observational study

“…Given aging is associated with decreased medication adherence caused by factors such as cognitive decline and dysphagia [ 25 ], it can be an important factor when considering continued medication self-management. A previous study reported a negative correlation between aging and medication self-management [ 26 ]; the results of the present study support the previous report.…”

The impact of lesion location on medication self-management ability in patients with cerebrovascular disease

“…The common factors associated with the introduction of medication self-management in Group R and Group L were age and FIM cognitive score. The FIM motor score was also identified in Group R. In a preceding study on the introduction of medication selfmanagement in stroke patients, age, FIM motor items (walk/wheelchair), and FIM cognitive items (memory) were reported to be factors influencing the introduction of medication self-management [9], which are similar to our findings. However, the present study confirmed that "FIM motor items" affect Group R but have little association with Group L. This is because, since patients in Group L suffer impairment in the right arm, which is dominant for most patients, the inability to maintain dexterity presumably led to greater dependence on cognitive skills than motor skills.…”

“…One limitation of this study is that there was a significant difference in age in the patient background between Group L and Group R. Age has been reported to be a negative factor in the achievement of medication self-management in stroke patients [9]. In this study, the mean age was higher in Group R than in Group L, and thus data on the non-self-management in Group R unavoidably affected the analysis.…”

Testing the validity and reliability of the Self‐Administration of Medication (SAM) instrument in Chinese chronic disease patients: A cross‐cultural adaptation

“…Self‐Administration of Medication (SAM) involves allowing patients to take their own medications in hospital, under varying levels of supervision from health professionals such as pharmacists, nurses, or doctors (Manias, Beanland, Riley, & Baker, ). Self‐Administration of Medication is an important aspect of chronic disease self‐management (Allen, Brownstein, Satsangi, & Escoffery, ; Fujihara et al, ; Hochberger & Lingham, ), since greater self‐medication capability can significantly reduce the risk of disease and the incidence of complications (Phelan, Kramer, Grieco, & Glassman, ). In addition, more than 90% of patients are willing to self‐administer drugs and 10% of them prefer participating in their care management with their family members' assistance or supervision (Resnick, ).…”