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50 岁以上人群中,基于患者访谈数据的处方药使用情况与药房记录的一致性因治疗分组和所报告的适应证健康状况而异。

Agreement between patient interview data on prescription medication use and pharmacy records in those aged older than 50 years varied by therapeutic group and reporting of indicated health conditions.

机构信息

The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland; Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland.

出版信息

J Clin Epidemiol. 2013 Nov;66(11):1308-16. doi: 10.1016/j.jclinepi.2013.02.016. Epub 2013 Aug 19.

Abstract

OBJECTIVES

To estimate the agreement between interview-ascertained medication use and pharmacy records among the population aged older than 50 years, and to identify patient-level predictors of discordance.

STUDY DESIGN AND SETTING

The Irish Longitudinal study on Ageing is representative of community-dwelling adults aged 50 years and older in Ireland. Interview-ascertained medication data from 2,621 participants were linked to pharmacy dispensing records. The kappa statistics measured the agreement between the two sources for 19 therapeutic classes. Logistic regression assessed the effect of patient-level characteristics on survey under- and overreporting of regularly dispensed medications.

RESULTS

Agreement was good or very good (κ=0.64-0.86) for 15 medication classes, and moderate or poor for antiinflammatory and antirheumatic products (κ=0.54), analgesics (κ=0.50), psycholeptics (κ=0.59), and ophthalmologicals (κ=0.37). Not reporting an indicated health condition, less frequent dispensing, older age, and more medications regularly dispensed were associated with survey underreporting, but results varied by therapeutic class. Memory and cognition were not associated with discordance.

CONCLUSION

Ascertaining medication use via patient interview seems a valid method for most medication classes and also captures nonprescription and supplement use. However, medications applied topically and as needed may be underreported. The source of medication data should be carefully considered when performing pharmacoepidemiological studies.

摘要

目的

评估 50 岁以上人群中通过访谈确定的药物使用与药房记录之间的一致性,并确定患者水平的不相符因素。

研究设计和设置

爱尔兰老龄化纵向研究是对爱尔兰社区居住的 50 岁及以上成年人的代表性研究。2621 名参与者的访谈确定的药物数据与药房配药记录相联系。Kappa 统计量用于测量两种来源在 19 种治疗类别中的一致性。逻辑回归评估了患者特征对常规配药药物调查少报和多报的影响。

结果

对于 15 种药物类别,一致性良好或非常好(κ=0.64-0.86),而抗炎和抗风湿产品(κ=0.54)、镇痛药(κ=0.50)、精神安定药(κ=0.59)和眼科用药(κ=0.37)的一致性为中等或较差。未报告指明的健康状况、配药频率较低、年龄较大以及更多常规配药的药物与调查少报有关,但结果因治疗类别而异。记忆和认知与不相符无关。

结论

通过患者访谈确定药物使用似乎是大多数药物类别的有效方法,并且还可以捕捉非处方和补充剂的使用。然而,局部和按需使用的药物可能会少报。在进行药物流行病学研究时,应仔细考虑药物数据的来源。

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