Validity assessment of self-reported medication use by comparing to pharmacy insurance claims.
Validity assessment of self-reported medication use by comparing to pharmacy insurance claims.
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DOI：
10.1136/bmjopen-2015-009490
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发表时间：
2015-11-09
期刊：
影响因子：
2.9
通讯作者：
Hata A
中科院分区：
文献类型：
--
作者：
Fujita M;Sato Y;Nagashima K;Takahashi S;Hata A
在日本，2008年根据《老年人医疗保障法》制定了年度健康检查和健康促进指导方案。关于药物使用情况的自我报告问卷是该方案的一个必要项目，已被广泛使用，但其有效性尚未得到评估。本研究的目的是通过比较自我报告的使用药房保险索赔，以评估此问卷的有效性。这是一项基于人群的验证研究。自我报告的高血压、糖尿病和血脂异常药物使用是评价的指标。药房保险索赔的数据被用作参考标准。参与者是千叶市国民健康保险的54 712名受益人。 计算自报药物使用问卷预测1个月（检查时）和3个月（检查时和前2个月）实际处方的敏感性、特异性和κ统计量。 问卷资料预测3个月保险理赔的敏感度和特异度 分别为92.4%（95% CI 91.9至92.8）和86.4%（95% CI 86.0 - 86.7）高血压，82.6%糖尿病为86.2%（95% CI 85.5 - 86.8）和91.0%（95% CI 90.8 - 91.3），血脂异常为98.5%（95% CI 98.4 - 98.6）。相应的κ统计量分别为70.9%（95% CI 70.1 - 71.7）、77.1%（95% CI 76.2 - 77.9）和69.8%（95% CI 68.9 - 70.6）。对于所有3种情况，覆盖3个月的问卷数据的特异性显著高于覆盖1个月的数据。 自我报告的药物使用问卷数据有足够高的效度进行进一步分析。项目反应与实际处方密切相关，特别是那些涵盖3个月的处方。
In Japan, an annual health check-up and health promotion guidance programme was established in 2008 in accordance with the Act on Assurance of Medical Care for the Elderly. A self-reported questionnaire on medication use is a required item in this programme and has been used widely, but its validity has not been assessed. The aim of this study was to evaluate the validity of this questionnaire by comparing self-reported usage to pharmacy insurance claims. This is a population-based validation study. Self-reported medication use for hypertension, diabetes and dyslipidaemia is the evaluated measurement. Data on pharmacy insurance claims are used as a reference standard. Participants were 54 712 beneficiaries of the National Health Insurance of Chiba City. Sensitivity, specificity and κ statistics of the self-reported medication-use questionnaire for predicting actual prescriptions during 1 month (that of the check-up) and 3 months (that of the check-up and the previous 2 months) were calculated. Sensitivity and specificity scores of questionnaire data for predicting insurance claims covering 3 months were, respectively, 92.4% (95% CI 91.9 to 92.8) and 86.4% (95% CI 86.0 to 86.7) for hypertension, 82.6% (95% CI 81.1 to 84.0) and 98.5% (95% CI 98.4 to 98.6) for diabetes, and 86.2% (95% CI 85.5 to 86.8) and 91.0% (95% CI 90.8 to 91.3) for dyslipidaemia. Corresponding κ statistics were 70.9% (95% CI 70.1 to 71.7), 77.1% (95% CI 76.2 to 77.9) and 69.8% (95% CI 68.9 to 70.6). The specificity was significantly higher for questionnaire data covering 3 months compared with data covering 1 month for all 3 conditions. Self-reported questionnaire data on medication use had sufficiently high validity for further analyses. Item responses showed close agreement with actual prescriptions, particularly those covering 3 months.