Self-reported medication use validated through record linkage to national prescribing data.
Self-reported medication use validated through record linkage to national prescribing data.
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DOI：
10.1016/j.jclinepi.2017.10.013
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发表时间：
2018-03
影响因子：
7.2
通讯作者：
McIntosh AM
中科院分区：
文献类型：
--
作者：
Hafferty JD;Campbell AI;Navrady LB;Adams MJ;MacIntyre D;Lawrie SM;Nicodemus K;Porteous DJ;McIntosh AM
研究人员需要对通过自我报告量化用药的流行病学研究的可靠性充满信心。一些证据表明，精神科药物被系统性地漏报了。现代记录链接能够以国家处方数据作为黄金标准来验证自我报告。在这里，我们调查了多种用药类型的用药自我报告的有效性。苏格兰世代人群队列(N=10,244)的参与者招募了2009-2011年自我报告的几个常用药物类别的定期使用。这与使用3个月和6个月固定时间窗口的苏格兰NHS处方数据进行了匹配。不和谐自我报告的潜在预测因素，包括一般智力和心理困扰，通过多变量Logistic回归进行了研究。抗抑郁药物的自我报告显示出非常好的一致性(κ=0.85，[95%可信区间(CI)0.84~0.87])，与抗高血压药(κ=0.90[CI 0.89~0.91])相当。情绪稳定剂的自我报告显示中度-较差的一致性(κ=0.42[CI 0.33-0.50])。相关的既往病史是自我报告敏感性的最强预测因子，而一般智力不能预测。在这项以人群为基础的大型研究中，我们发现自我报告的有效性因药物类别的不同而不同，精神药物和报告不足之间没有简单的关系。精神科和非精神科药物的病史预示着更准确的自我报告。尽管其他患者水平的因素会影响某些药物的自我报告，但没有人预测在所有研究的药物中都会有更高的准确性。
Researchers need to be confident about the reliability of epidemiologic studies that quantify medication use through self-report. Some evidence suggests that psychiatric medications are systemically under-reported. Modern record linkage enables validation of self-report with national prescribing data as gold standard. Here, we investigated the validity of medication self-report for multiple medication types. Participants in the Generation Scotland population-based cohort (N = 10,244) recruited 2009–2011 self-reported regular usage of several commonly prescribed medication classes. This was matched against Scottish NHS prescriptions data using 3- and 6-month fixed time windows. Potential predictors of discordant self-report, including general intelligence and psychological distress, were studied via multivariable logistic regression. Antidepressants self-report showed very good agreement (κ = 0.85, [95% confidence interval (CI) 0.84–0.87]), comparable to antihypertensives (κ = 0.90 [CI 0.89–0.91]). Self-report of mood stabilizers showed moderate-poor agreement (κ = 0.42 [CI 0.33–0.50]). Relevant past medical history was the strongest predictor of self-report sensitivity, whereas general intelligence was not predictive. In this large population-based study, we found self-report validity varied among medication classes, with no simple relationship between psychiatric medication and under-reporting. History of indicated illness predicted more accurate self-report, for both psychiatric and nonpsychiatric medications. Although other patient-level factors influenced self-report for some medications, none predicted greater accuracy across all medications studied.
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影响因子：
5.4
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通讯作者：
Howe, GR
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GOLDBERG, DP;HILLIER, VF
通讯作者：
HILLIER, VF
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通讯作者：
Fresco P
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