Factors predicting the inability to self-manage medication after discharge from the intensive care unit: a retrospective cohort study

Objectives: This study aimed to identify factors associated with medication non-adherence at hospital discharge and calculate cut-off values for these factors. Methods: A logistic regression model was prepared using a retrospective dataset of 141 cases. Age, sex, the number of drugs prescribed after ICU discharge, the score on the motor and cognitive compo-nents of the functional independence measure (FIM), and the Charlson comorbidity index score were analyzed as potential independent risk factors for medication non-adherence after discharge. Cut-off values and diagnostic accuracy were evaluated by receiver operating characteristic curve, and the results were calibrated against another retrospective dataset of 72 cases, which was collected over a different period. Results: The age ≥ 75 years (OR 3.81, 95%CI 1.33–10.9) and scoring ≤ 4 on more than one item in the cognitive component of the FIM were found to be independent risk factors for medication non-adherence after ICU discharge. A FIM cognitive score cut-off of ≤ 26 had high diagnostic accuracy (sensitivity 62.5%, specificity 88.1%), and the accuracy ratio was highly consistent between the two datasets. Conclusions: The FIM cognitive score and age at ICU admission were independent risk factors for medication non-adherence after discharge, and the diagnostic accuracy was highest for a FIM cognitive score cut-off of 26 points or less.