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.