Algorithm for initiation of medication self-management training based on FIM (AIMS-F) in stroke patients

Abstract

Furusato K, Nagao T, Taketani M, Nakazono H, Noguchi D, Watanabe S. Algorithm for initiation of medication self-management training based on FIM (AIMS-F) in stroke patients. Jpn J Compr Rehabil Sci 2013; 4: 14-16. Objective: Medication management is an important factor for the prevention of deterioration or recurrence of cerebral infarction. Aiming at early achievement of independence in medication, we developed a new algorithm for initiating medication self-management training based on the Functional independence Measure (FIM) scale, which we abbreviated as AIMS-F. Methods: Stroke patients who ultimately achieved independence in medication management were analyzed retrospectively. The patients were divided into two groups: a group that required self-help devices for management and a group that was able to manage with medication bags, at the initiation of training. From the scores of five items in the FIM scale (bladder control, bowel control, grooming, memory, and social interaction), the choice of the optimal initiation method (self-help devices or medication bags) was predicted. Logistic regression analysis was conducted to find the cutoff point at which training can be initiated with medication bags. Results: The receiver operating characteristic curve (ROC) that fitted the logistic model had an area under the curve (AUC) of 82%. The cutoff point of the total score of five FIM items was 32. At this cutoff, sensitivity was 85% and specificity was 64%. Conclusion: This study demonstrated the usefulness of AIMS-F to standardize the initiation of medication self-management training. By introducing the AIMS-F, the timing and the method of initiating medication self-management training are clearly indicated, which may provide a standardized approach that allows early achievement self-management.