BACKGROUND: Many studies of medicine use rely on self-reports. Based on pharmacy claims data, this analysis tests whether such self-reports constitute a valid and reliable data source. DATA AND METHODS: Linked data from the Canadian Community Health Survey and the Ontario Drug Benefit Program were used to estimate the agreement, based on kappa statistics, between seniors' self-reported medication use and the claims data. Health, demographic and socio-economic factors associated with the likelihood of agreement were modeled with logistic regression. RESULTS: The prevalence of antihypertensive medication use among Ontario residents aged 65 or older was about 40% in 2001, based on both self-report and pharmacy claims, and in 2005, it was 52% for self-report and 49% based on claims data. The prevalence of oral diabetes medication use was comparable between the two data sources. Overall agreement between self-reported and claims data was "good" to "very good" for oral diabetes medications (kappa = 0.79 in 2001; 0.87 in 2005), but "moderate" for antihypertensive medications (kappa = 0.46 in 2001; 0.55 in 2005). Agreement improved somewhat from 2001 to 2005, with implementation of a more targeted survey question. INTERPRETATION: Self-reports appear to be an accurate data source for measuring medication use; however, for antihypertensive medications, self-reports by the oldest and sickest subpopulations should be used cautiously.
BACKGROUND: Many studies of medicine use rely on self-reports. Based on pharmacy claims data, this analysis tests whether such self-reports constitute a valid and reliable data source. DATA AND METHODS: Linked data from the Canadian Community Health Survey and the Ontario Drug Benefit Program were used to estimate the agreement, based on kappa statistics, between seniors' self-reported medication use and the claims data. Health, demographic and socio-economic factors associated with the likelihood of agreement were modeled with logistic regression. RESULTS: The prevalence of antihypertensive medication use among Ontario residents aged 65 or older was about 40% in 2001, based on both self-report and pharmacy claims, and in 2005, it was 52% for self-report and 49% based on claims data. The prevalence of oral diabetes medication use was comparable between the two data sources. Overall agreement between self-reported and claims data was "good" to "very good" for oral diabetes medications (kappa = 0.79 in 2001; 0.87 in 2005), but "moderate" for antihypertensive medications (kappa = 0.46 in 2001; 0.55 in 2005). Agreement improved somewhat from 2001 to 2005, with implementation of a more targeted survey question. INTERPRETATION: Self-reports appear to be an accurate data source for measuring medication use; however, for antihypertensive medications, self-reports by the oldest and sickest subpopulations should be used cautiously.
Entities:
Keywords:
aged; antihypertensive agents; diabetes; drug prescriptions; drug utilization; health surveys
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