{"title":"A comparative analysis of medication counting methods to assess polypharmacy in medico-administrative databases","authors":"","doi":"10.1016/j.sapharm.2024.05.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The variety of methods for counting medications may lead to confusion when attempting to compare the extent of polypharmacy across different populations.</p></div><div><h3>Objective</h3><p>To compare the prevalence estimates of polypharmacy derived from medico-administrative databases, using different methods for counting medications.</p></div><div><h3>Methods</h3><p>Data were drawn from the Québec Integrated Chronic Disease Surveillance System. A random sample of 110,000 individuals aged >65 was selected, including only those who were alive and covered by the public drug plan during the one-year follow-up. We used six methods to count medications: #1-cumulative one-year count, #2-average of four quarters' cumulative counts, #3-count on a single day, #4-count of medications used in first and fourth quarters, #5-count weighted by duration of exposure, and #6-count of uninterrupted medication use. Polypharmacy was defined as ≥5 medications. Cohen's Kappa was calculated to assess the level of agreement between the methods.</p></div><div><h3>Results</h3><p>A total of 93,516 (85 %) individuals were included. The prevalence of polypharmacy varied across methods. The highest prevalence was observed with cumulative methods (#1:74.1 %; #2:61.4 %). Single day count (#3:47.6 %), first and fourth quarters count (#4:49.5 %), and weighted count (#5:46.6 %) yielded similar results. The uninterrupted use count yielded the lowest estimate (#6:35.4 %). The weighted method (#5) showed strong agreement with the first and fourth quarters count (#4). Cumulative methods identified higher proportions of younger, less multimorbid individuals compared to other methods.</p></div><div><h3>Conclusion</h3><p>Counting methods significantly affect polypharmacy prevalence estimates, necessitating their consideration when comparing and interpretating results.</p></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S155174112400175X/pdfft?md5=04fbb1ff4fc0e9cfbcd446a87377fc88&pid=1-s2.0-S155174112400175X-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research in Social & Administrative Pharmacy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S155174112400175X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The variety of methods for counting medications may lead to confusion when attempting to compare the extent of polypharmacy across different populations.
Objective
To compare the prevalence estimates of polypharmacy derived from medico-administrative databases, using different methods for counting medications.
Methods
Data were drawn from the Québec Integrated Chronic Disease Surveillance System. A random sample of 110,000 individuals aged >65 was selected, including only those who were alive and covered by the public drug plan during the one-year follow-up. We used six methods to count medications: #1-cumulative one-year count, #2-average of four quarters' cumulative counts, #3-count on a single day, #4-count of medications used in first and fourth quarters, #5-count weighted by duration of exposure, and #6-count of uninterrupted medication use. Polypharmacy was defined as ≥5 medications. Cohen's Kappa was calculated to assess the level of agreement between the methods.
Results
A total of 93,516 (85 %) individuals were included. The prevalence of polypharmacy varied across methods. The highest prevalence was observed with cumulative methods (#1:74.1 %; #2:61.4 %). Single day count (#3:47.6 %), first and fourth quarters count (#4:49.5 %), and weighted count (#5:46.6 %) yielded similar results. The uninterrupted use count yielded the lowest estimate (#6:35.4 %). The weighted method (#5) showed strong agreement with the first and fourth quarters count (#4). Cumulative methods identified higher proportions of younger, less multimorbid individuals compared to other methods.
Conclusion
Counting methods significantly affect polypharmacy prevalence estimates, necessitating their consideration when comparing and interpretating results.
期刊介绍:
Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues.