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Pharmacoepidemiol Drug Saf. 2016 Jul;25(7):827-35. doi: 10.1002/pds.3970. Epub 2016 Jan 29.

Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.

Author information

1
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
2
Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA.
3
Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
4
Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.

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.

KEYWORDS:

Medicare Part D; drug; drug prescriptions; hydroxymethylglutaryl-CoA reductase inhibitors; insurance claim review; pharmacoepidemiology; utilization

PMID:
26823152
PMCID:
PMC5039944
DOI:
10.1002/pds.3970
[Indexed for MEDLINE]
Free PMC Article

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