Cheung K, El Marroun H, Elfrink M E, Jaddoe V W V, Visser L E, Stricker B H Ch
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Inspectorate of Health Care, Utrecht, The Netherlands.
Pharmacoepidemiol Drug Saf. 2017 Sep;26(9):1119-1125. doi: 10.1002/pds.4264. Epub 2017 Jul 25.
Several studies have been conducted to assess determinants affecting the performance or accuracy of self-reports. These studies are often not focused on pregnant women, or medical records were used as a data source where it is unclear if medications have been dispensed. Therefore, our objective was to evaluate the concordance between self-reported medication data and pharmacy records among pregnant women and its determinants.
We conducted a population-based cohort study within the Generation R study, in 2637 pregnant women. The concordance between self-reported medication data and pharmacy records was calculated for different therapeutic classes using Yule's Y. We evaluated a number of variables as determinant of discordance between both sources through univariate and multivariate logistic regression analysis.
The concordance between self-reports and pharmacy records was moderate to good for medications used for chronic conditions, such as selective serotonin reuptake inhibitors or anti-asthmatic medications (0.88 and 0.68, respectively). Medications that are used occasionally, such as antibiotics, had a lower concordance (0.51). Women with a Turkish or other non-Western background were more likely to demonstrate discordance between pharmacy records and self-reported data compared with women with a Dutch background (Turkish: odds ratio, 1.63; 95% confidence interval, 1.16-2.29; other non-Western: odds ratio, 1.33; 95% confidence interval, 1.03-1.71).
Further research is needed to assess how the cultural or ethnic differences may affect the concordance or discordance between both medication sources. The results of this study showed that the use of multiple sources is needed to have a good estimation of the medication use during pregnancy.
已开展多项研究来评估影响自我报告表现或准确性的决定因素。这些研究通常未聚焦于孕妇，或者使用医疗记录作为数据源，而在这些记录中尚不清楚药物是否已配出。因此，我们的目标是评估孕妇自我报告的用药数据与药房记录之间的一致性及其决定因素。
我们在“R代研究”中对2637名孕妇进行了一项基于人群的队列研究。使用尤尔Y系数计算不同治疗类别的自我报告用药数据与药房记录之间的一致性。我们通过单变量和多变量逻辑回归分析评估了许多变量作为两种数据源之间不一致的决定因素。
对于用于慢性疾病的药物，如选择性5-羟色胺再摄取抑制剂或抗哮喘药物，自我报告与药房记录之间的一致性为中等至良好（分别为0.88和0.68）。偶尔使用的药物，如抗生素，一致性较低（0.51）。与具有荷兰背景的女性相比，具有土耳其或其他非西方背景的女性在药房记录和自我报告数据之间更有可能出现不一致（土耳其：比值比，1.63；95%置信区间，1.16 - 2.29；其他非西方：比值比，1.33；95%置信区间，1.03 - 1.71）。
需要进一步研究以评估文化或种族差异如何影响两种用药数据源之间的一致性或不一致性。本研究结果表明，需要使用多种来源才能对孕期用药情况进行良好估计。
