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

Hisato Fujihara,Isao Saito,Masazumi Mizuma,Hiroko Suzuki,Nobuyuki Kawate,Jun-Ichiro Murayama,Mari Kogo,Tadanori Sasaki

doi:10.1186/s40780-016-0070-7

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.

Highlights

Medication 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 to predict if medication self-management would be effective for stroke patients using functional independence measure (FIM) items and patient data, including medication-related information
Evaluation of the validity of the prediction formula We evaluated the validity of the formula by using the degrees of freedom adjusted R2 statistic, lack of fit (LOF), and area under the receiver operating characteristic (ROC) curve, which provides an index indicating the association of the sensitivity and the specificity

Summary

Introduction

Medication 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. Stroke patients admitted to a Kaifukuki rehabilitation ward often develop cognitive impairment. The medication self-management has not been appropriately evaluated for stroke patients, it is important to prevent further disease progression and incidence of side effects. Pharmacists who work in a Kaifukuki rehabilitation ward must support introduction of safe medication selfmanagement and prevent medication errors in stroke patients. The mission of hospital pharmacists is to help patients achieve optimal medication selfmanagement during hospitalization. Decisions regarding whether to introduce medication selfmanagement for stroke patients should be based on optimal objective indicators

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Conclusion