Research Center, CHU Sainte-Justine, Montreal, Canada.
Faculty of Pharmacy, University of Montreal, Montreal, Canada.
Birth Defects Res. 2017 Apr 3;109(6):423-431. doi: 10.1002/bdra.23604. Epub 2017 Mar 9.
Administrative databases are increasingly used to measure drug exposure in perinatal pharmacoepidemiology. We aimed to estimate the concordance between records of prescriptions filled in pharmacies and self-reported drug use during pregnancy.
Data on self-reported medication use were collected at each trimester of pregnancy among a sub-sample from the Organization of Teratology Information Specialists Antidepressants in Pregnancy Cohort. Women were eligible if they were Quebec resident and provided their pharmacist's contact information. Maternal self-reports were compared with prescriptions filled in pharmacies, which are transferred to pharmaceutical services files of Quebec provincial health plan database (Régie de l'asssurance maladie du Québec). Positive and negative predictive values (PPV and NPV) for medications taken chronically (antidepressants, thyroid hormones), acutely (antibiotics), and as needed (antiemetics, asthma medications) were calculated.
Among the 93 participants (mean age = 30.2 ± 3.8 years), 41.9% (n = 39) took at least one antidepressant during pregnancy according to self-reports, and 39.8% (n = 37) according to pharmacy records. Other commonly used drugs were antiemetics (self-reported 22.6%, pharmacy record 24.7%), antibiotics (20.4%, 16.1%), asthma medications (15.1%, 15.1%), and thyroid hormones (10.8%, 8.6%). PPVs and NPVs were: (1) chronic medication: antidepressants PPV = 100% (95% confidence interval [CI], 100-100%), NPV = 96% (95% CI, 92-100%); thyroid hormones PPV = 100% (95% CI, 100-100%), NPV = 98% (95% CI, 95-100%); (2) Acute medication: antibiotics PPV = 87% (95% CI, 70-100%), NPV = 92% (95% CI, 86-98%); (3) as needed medications: antiemetics: PPV = 78% (95% CI, 62-95%), NPV = 96% (95% CI, 91-100%); asthma: PPV = 33% (95% CI, 3-64%), NPV = 99% (95% CI, 97-100%).
The high PPV and NPV validate the use of filled prescription data in large databases as a measure of medication exposure. Birth Defects Research 109:423-431, 2017. © 2017 Wiley Periodicals, Inc.
行政数据库越来越多地用于围产期药物流行病学中的药物暴露测量。我们旨在估计在药房填写的处方记录与怀孕期间自我报告的药物使用之间的一致性。
在组织毒理学信息专家抗抑郁药妊娠队列的子样本中，在每个孕期 trimester 收集自我报告的药物使用数据。如果女性是魁北克居民并提供了药剂师的联系方式，则有资格参加。将产妇自我报告与药房填写的处方进行比较，这些处方会被转移到魁北克省级健康计划数据库（魁北克省健康保险局）的药品服务文件中。计算了长期（抗抑郁药、甲状腺激素）、急性（抗生素）和按需（止吐药、哮喘药物）使用的药物的阳性预测值（PPV）和阴性预测值（NPV）。
在 93 名参与者中（平均年龄为 30.2±3.8 岁），根据自我报告，有 41.9%（n=39）在怀孕期间至少服用了一种抗抑郁药，而根据药房记录，有 39.8%（n=37）服用了这种药物。其他常用药物包括止吐药（自我报告 22.6%，药房记录 24.7%）、抗生素（20.4%，16.1%）、哮喘药物（15.1%，15.1%）和甲状腺激素（10.8%，8.6%）。PPV 和 NPV 如下：（1）慢性药物：抗抑郁药 PPV=100%（95%置信区间[CI]，100-100%），NPV=96%（95%CI，92-100%）；甲状腺激素 PPV=100%（95%CI，100-100%），NPV=98%（95%CI，95-100%）；（2）急性药物：抗生素 PPV=87%（95%CI，70-100%），NPV=92%（95%CI，86-98%）；（3）按需药物：止吐药：PPV=78%（95%CI，62-95%），NPV=96%（95%CI，91-100%）；哮喘：PPV=33%（95%CI，3-64%），NPV=99%（95%CI，97-100%）。
高 PPV 和 NPV 验证了在大型数据库中使用已填处方数据作为药物暴露测量的有效性。出生缺陷研究 109:423-431,2017。© 2017 威利父子公司。
