Assessing agreement between population-level administrative pharmaceutical databases and patient-reported medication dispensation in cardiac rehabilitation patients.

Danielle A Southern, Codie Rouleau, Stephen B Wilton, Sandeep G Aggarwal, Michelle M Graham, Erik Youngson, Finlay A McAlister, Hude Quan
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Abstract

Background: Pharmacoepidemiology has emerged as a crucial field in evaluating the use and effects of medications in large populations to ensure their safe and effective use. This study aimed to assess the agreement of cardiac medication use between a provincial medication database, the Pharmaceutical Information Network (PIN), and reconciled medication data from confirmation through patient interviews for patients referred to cardiac rehabilitation.

Methods: The study included data from patients referred to the TotalCardiology Rehabilitation CR program, and medication data was available in both TotalCardiology Rehabilitation charts and PIN. The accuracy of medication data obtained from patient interviews was compared to that obtained from PIN with proportions and kappa statistics to evaluate the reliability of PIN data in assessing medication use.

Results: Patient-reported usage was higher for statins (41.6 %) vs. 38.4 %), ACE/ARB, beta-blockers (75.7 %) vs. 73.7 %), DOAC (3.5 %) vs. 2.6 %), and ADP-receptor antagonists (71.0 %) vs. 68.1 %) than if PIN was used. Patient-reported usage data was lower for Ezetimibe (4.7 vs. 4.8 %), Aldosterone antagonists (5.4 %) vs. 5.5 %), digoxin (0.9 %) vs. 1.0 %), calcium channel blockers (19.2 vs. 19.9 %) and warfarin (7.2 %) vs. 8.1 %). The results indicated that the differences between the two sources were very small, with an average agreement of 95.3 % and a kappa of 0.70.

Conclusion: The study's results, which show a high level of agreement between PIN and patient self-reporting, affirm the reliability of PIN data as a source for obtaining an accurate assessment of medication use. This finding is crucial in the context of pharmacoepidemiology research, where the accuracy of data is paramount. Further research to explore the complementary use of both data sources will be valuable.

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评估人口级行政药物数据库与患者报告的心脏康复患者药物分配之间的一致性。
背景:药物流行病学已成为评估药物在大量人群中的使用情况和效果以确保其安全有效使用的一个重要领域。本研究旨在评估省级药物数据库--药品信息网(PIN)--与通过对转诊至心脏康复中心的患者进行访谈确认的药物数据之间的一致性:研究包括转诊至 TotalCardiology Rehabilitation CR 项目的患者数据,TotalCardiology Rehabilitation 病历和 PIN 均提供了用药数据。用比例和卡帕统计法比较了从患者访谈中获得的用药数据和从 PIN 中获得的用药数据的准确性,以评估 PIN 数据在评估用药情况方面的可靠性:患者报告的他汀类药物(41.6%)与 38.4%)、ACE/ARB、β-受体阻滞剂(75.7%)与 73.7%)、DOAC(3.5%)与 2.6%)和 ADP 受体拮抗剂(71.0%)与 68.1%)的使用率均高于使用 PIN 的情况。患者报告的使用数据中,依折麦布(4.7% 对 4.8%)、醛固酮拮抗剂(5.4% 对 5.5%)、地高辛(0.9% 对 1.0%)、钙通道阻滞剂(19.2% 对 19.9%)和华法林(7.2% 对 8.1%)的使用率较低。)结果表明,两个来源之间的差异非常小,平均一致性为 95.3%,卡帕值为 0.70:研究结果表明,PIN 与患者自我报告之间的一致性很高,这肯定了 PIN 数据作为准确评估药物使用情况的来源的可靠性。这一结果对于数据准确性至关重要的药物流行病学研究至关重要。进一步研究探索这两种数据来源的互补使用将非常有价值。
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