Premium
Agreement between Medicare pharmacy claims, self‐report, and medication inventory for assessing lipid‐lowering medication use
Author(s) -
Colantonio Lisandro D.,
Kent Shia T.,
Kilgore Meredith L.,
Delzell Elizabeth,
Curtis Jeffrey R.,
Howard George,
Safford Monika M.,
Muntner Paul
Publication year - 2016
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3970
Subject(s) - medicine , pharmacy , confidence interval , family medicine , cohen's kappa , demography , machine learning , sociology , computer science
Abstract Background Medicare claims have been used to study lipid‐lowering medication (LLM) use among US adults. Methods We analyzed the agreement between Medicare claims for LLM and LLM use indicated by self‐report during a telephone interview and, separately, by a medication inventory performed during an in‐home study visit upon enrollment into the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. We included REGARDS participants ≥65 years enrolled in 2006–2007 with Medicare pharmacy benefits (Part D) from 120 days before their telephone interview through their medication inventory ( n = 899). Results Overall, 39.2% and 39.5% of participants had a Medicare claim for an LLM within 120 days prior to their interview and medication inventory, respectively. Also, 42.7% of participants self‐reported using LLMs, and 41.8% had an LLM in their medication inventory. The Kappa statistic (95% confidence interval [CI]) for agreement of Medicare claims with self‐report and medication inventory was 0.68 (0.63–0.73) and 0.72 (0.68–0.77), respectively. No Medicare claims for LLMs were present for 22.1% (95%CI: 18.1–26.6%) of participants who self‐reported taking LLMs and 18.9% (15.1–23.3%) with LLMs in their medication inventory. Agreement between Medicare claims and self‐report was lower among Black male individuals (Kappa = 0.34 [95%CI: 0.14–0.54]) compared with Black female individuals (0.70 [0.61–0.79]), White male individuals (0.65 [0.56–0.75]), and White female individuals (0.79 [0.72–0.86]). Agreement between Medicare claims and the medication inventory was also low among Black male individuals (Kappa = 0.48 [95%CI: 0.29–0.66]). Conclusions Although substantial agreement exists, many Medicare beneficiaries who self‐report LLM use or have LLMs in a medication inventory have no claims for these medications. Copyright © 2016 John Wiley & Sons, Ltd.