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August 27, 2014
Stroke Survivors Often Over-Estimate Ability to
Follow Drug Regimens 

West Orange, NJ—Pharmacists should be aware that stroke patients who are over-optimistic about their ability to take medications accurately might actually be demonstrating memory deficits.

A new study suggests an association between those strong assurances and memory loss among stroke survivors.

The study, led by Kessler Foundation researchers, was published online recently by the journal Brain Injury.

“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,” study authors write. “Complicating this matter, stroke survivors may not be aware of their [cognitive anosognosia] and may over-estimate their MSA competence.”

For the study, researchers compared 24 stroke survivors with 17 controls, using the Hopkins Medication Schedule to assess medication self-adherence (MSA), the Geriatric Depression Scale to assess mood, and the Hopkins Verbal Test and Mini-Mental State Examination to assess memory. Results indicated that stroke survivors often over-estimated their MSA in comparison to controls and that over-estimation of MSA correlated strongly with verbal memory deficit.

“While some stroke survivors have obvious cognitive deficits, many people are not aware that stroke survivors can be intelligent and high functioning, but still have trouble with thinking that can cause errors in medication self-management,” lead author A.M. Barrett, MD, pointed out. “These individuals may not realize their own deficits, a condition called cognitive anosognosia. Screening stroke survivors for MSA may be a useful approach to identifying memory deficits that hinder rehabilitation and community participation and contribute to poor outcomes.”

Study authors call for larger studies of left and right stroke survivors to determine the underlying mechanisms for both over-estimation and under-estimation of self-performance.

The report also suggests that “assessing medication self-administration and MSA self-awareness may be useful in rehabilitation and successful community-return after stroke.”


U.S. Pharmacist Social Connect