Kyoko Furusato, Ns, Taeko Nagao, Ns, Masao Taketani, ST, Hisato Nakazono, OT,
Noguchi Daisuke, PT, Susumu Watanabe, MD, PhD
Jpn J Compr Rehabil Sci 4: 14-16, 2013
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.
Key words: FIM, early self-management of medication, algorithm, medication management method, stroke patient