Are Patients Reliable When Self‐Reporting Medication Use? Validation of Structured Drug Interviews and Home Visits by Drug Analysis and Prescription Data in Acutely Hospitalized Patients¹

Abstract

The medication history among hospitalized patients often relies on patients' self-reports due to insufficient communication between health care professionals. The aim of the present study was to estimate the reliability of patients' self-reported medication use. Five hundred patients admitted to an acute medical department at a Danish university hospital were interviewed on the day of admission about their recent medication use. Blood samples drawn immediately after admission were screened for contents of 5 drugs (digoxin, bendroflumethiazide, amlodipine, simvastatin, glimepiride), and the results were compared to the patients' self-reported medication history. Information on prescribed drugs dispensed from any Danish pharmacy was collected from nationwide real-time pharmacy records. The authors performed home visits in a subgroup of 115 patients 4 weeks after their discharge. Stored drugs were inspected, and patients were interviewed about their drug use. Additional blood samples were drawn for drug analysis. The median age of included patients was 72 years, and 298 patients (60%) were women. Patients reported use of 3 (median) prescription-only medications (range, 0-14) during the structured interview. The congruence between self-report and drug analysis was high for all 5 drugs measured (all kappa >0.8). However, 9 patients (2%) reported use of drugs that were not detected in their blood samples. In 29 patients (6%), the blood samples contained drugs not reported during the structured interview, but 14 of these drugs were registered in either hospital files or pharmacy records. Overall, the sensitivity of information from hospital files, structured interviews, and pharmacy records in identifying drug users was 87% to 93%, with no significant differences between methods. In conclusion, patients' self-reports are reliable when estimating recent use of cardiovascular and antidiabetic drugs.

Potential drug–drug interactions and radiodiagnostic procedures: an in-hospital survey

“…Nevertheless, when administered close to hospitalization, self-reported cardiovascular and anti-diabetic drugs showed an acceptable reliability [22][23][24][25][26][27]. Therefore, since the majority of the prescriptions reported in our study regarded cardiovascular drugs, our findings were not weightily biased.…”

Drug information for patients—an update of long‐term results: type of enquiries and patient characteristics

“…However, there is evidence from the literature that self-reports by patients are reliable when compared to objectively obtained data. 45 …”

Agreement between different recall periods in drug utilization studies

“…This pattern suggests that the agreement varies with the therapeutic class of the drug 18,[20][21][22][23][24][25][26] and that the high agreement of self-reported drug use found for continuous drugs cannot be generalized to other types of drugs 24 . Drugs of continuous use to treat chronic diseases, such as cardiovascular system drugs, have been repeatedly observed to be more likely to be accurately reported by individuals than drugs of occasional use, as occasional use drugs are used for self-limiting diseases and for short periods or sporadically 27,28 .…”

“…The outcomes variables were the prevalence of drug use during the last 24 hours, 7, 14 or 30 days, obtained through the question: "Did you use any drugs in the last [24 In case of a positive response, the medication names were inquired. Sociodemographic and medical variables investigated included gender, age, self-reported race/color, family income, occupation at the university (professor, student or staff ), levels of education, health insurance plan, number of drugs in the 24 hours and number of drugs in the 7, 14 or 30 days.…”