Stroke survivors over-estimate their medication self-administration (MSA) ability, predicting memory loss.

BACKGROUND AND

OBJECTIVE

Medication self-administration (MSA) may be cognitively challenging after stroke, but guidelines are currently lacking for identifying high-functioning stroke survivors who may have difficulty with this task. Complicating this matter, stroke survivors may not be aware of their cognitive problems (cognitive anosognosia) and may over-estimate their MSA competence. The authors wished to evaluate medication self-administration and MSA self-awareness in 24 consecutive acute stroke survivors undergoing inpatient rehabilitation, to determine if they would over-estimate their medication self-administration and if this predicted memory disorder.

METHODS

Stroke survivors were tested on the Hopkins Medication Schedule and also their memory, naming mood and dexterity were evaluated, comparing their performance to 17 matched controls.

RESULTS

The anosognosia ratio indicated MSA over-estimation in stroke survivors compared with controls--no other over-estimation errors were noted relative to controls. A strong correlation was observed between over-estimation of MSA ability and verbal memory deficit, suggesting that formally assessing MSA and MSA self-awareness may help detect cognitive deficits.

CONCLUSIONS

Assessing medication self-administration and MSA self-awareness may be useful in rehabilitation and successful community-return after stroke.