Concordance between Patient Self-Reports and Claims Data on Clinical Diagnoses, Medication Use, and Health System Utilization in Taiwan

Wu, Chi‐Shin; Lai, Mei‐Shu; Gau, Susan Shur‐Fen; Wang, Sheng-Chang; Tsai, Hui‐Ju

doi:10.1371/journal.pone.0112257

Cited by 230 publications

(218 citation statements)

References 25 publications

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“…To our knowledge, this is the first study to compare DMT use, product, and adherence between self-report and pharmacy records in MS.Previous research on antidepressant [27] and general medication use [28] found substantial agreement (kappa of 0.69 and 0.64, respectively) between self-report and claims records in terms of drug use. We found near-perfect agreement between sources, suggesting that self-report truly reflects the actual DMT received.…”

Section: Discussionmentioning

confidence: 85%

Disease-Modifying Therapies and Adherence in Multiple Sclerosis: Comparing Patient Self-Report with Pharmacy Records

et al. 2017

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Background: Self-report and pharmacy records are often used to measure adherence rates to disease-modifying therapies (DMTs) in multiple sclerosis (MS), but little is known about how the sources compare. Objective: Compare self-report and pharmacy records for assessing DMT use and adherence rates. Methods: Demographic information, self-reported DMT use, and missed DMT doses in the previous 30 days were obtained from consecutive MS patients attending an MS clinic and linked to pharmacy records. A medication possession ratio (MPR) was calculated using pharmacy records for the year before and after the visit; MPR <80% defined nonadherence. Agreement between self-report and pharmacy records was assessed using Cohen's kappa (κ). Results: Of 326 participants, 135 reported using an injectable DMT. There was near-perfect and perfect agreement between self-report and pharmacy records for DMT use (κ = 0.95; 95% CI 0.91-0.98) and DMT agent (κ = 1.00). Nonadherence was estimated at 13% (17/128) from the 30-days self-report compared to 30% (34/113) and 43% (53/123) in the year pre- and post-clinic visit from pharmacy records, indicating moderate to fair agreement (year prior: κ = 0.41; 95% CI 0.22-0.59; year post: κ = 0.22; 95% CI 0.09-0.36). Conclusions: Patients self-reports closely reflected pharmacy records when assessing DMT use and product. Moderate to fair agreement was found when comparing adherence rates between sources.

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Section: Discussionmentioning

confidence: 85%

Disease-Modifying Therapies and Adherence in Multiple Sclerosis: Comparing Patient Self-Report with Pharmacy Records

et al. 2017

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“…As was the case in this study, multivariate analysis of the data from this probability survey estimated that hypertension and diabetes were significant risk factors for ED after controlling for age and other characteristics . Concordance between real‐world observational data and population survey epidemiological data has been variable in recent studies of other healthcare topics, including diabetes prevalence, myocardial infarction prevalence, in vitro fertilisation usage rates, mental health visit frequency, asthma medication possession, and clinical diagnosis, medication use and healthcare utilisation . Several factors may account for the differences in outcomes, including recall and non‐response bias, coding errors and self‐reported symptoms vs EHR or claims‐based diagnosis or treatment.…”

Section: Discussionmentioning

confidence: 99%

Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA

et al. 2016

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SUMMARY Aims With self-reporting of erectile dysfunction (ED) in population-based surveys, men with ED may not represent men who are bothered sufficiently to seek an ED diagnosis and treatment. We used real-world observational data to assess: 1) the prevalence of ED diagnosis or treatment by age subgroups; and 2) the relationship of age with ED diagnosis or treatment after controlling for ED-related comorbidities in the United States. Methods This cross-sectional study used de-identified claims data (MarketScan® databases; primary analysis). Sensitivity analysis was conducted using electronic health records (Humedica® database). Inclusion criteria were men aged ≥18 years with a 360-day continuous enrollment before the index date. We assessed the prevalence of ED diagnosis or phosphodiesterase type 5 inhibitor (PDE5I) prescription by age and the risk for ED diagnosis or treatment by age after controlling for comorbidities (hypertension, other cardiovascular disease, diabetes mellitus, depression, and benign prostatic hyperplasia). Results Of 19,833,939 men meeting inclusion criteria in the primary analysis, only 1,108,842 (5.6%) had an ED diagnosis or PDE5I prescription (mean [SD] age: 55.2 [11.2] years). Prevalence of ED diagnosis or treatment increased from age 18–29 years (0.4%) to 60–69 years (11.5%), then decreased in the 7th (11.0%), 8th (4.6%), and 9th (0.9%) decades. Men with ED diagnosis or treatment had a higher prevalence of any comorbidity (63.1% vs 29.3% for men without ED) and of each comorbid condition. In multivariate analyses, age was an independent risk factor for ED diagnosis or treatment. Sensitivity analysis provided consistent results. Conclusions In a real-world setting in the United States, the prevalence of ED diagnosis or PDE5I treatment is generally low, increases with age, decreases in very old men, and is associated with increased prevalence of comorbidities. Age is an independent risk factor for ED diagnosis or treatment after controlling for comorbidities.

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“…All T2DM patients met the following criteria: (1) minimal four outpatient visits for T2DM, and (2) prescription of glycemic‐lowering drugs. The accuracy of T2DM diagnosis in this dataset has been validated . The index hospitalization was defined as that during which the patient was admitted for hip fracture surgery.…”

Section: Methodsmentioning

confidence: 99%

Chronic Kidney Disease Worsens Health Outcomes in Diabetic Patients After Hip Fracture Surgery: An Asian Nationwide Population-Based Cohort Study

Huang

Chen

Lin

et al. 2019

Journal of Bone and Mineral Research

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There is an increased tendency for hip fractures in patients with chronic kidney disease (CKD). Although surgery is the mainstay of treatment for hip fractures, there is scant information on outcomes after hip fracture surgery in diabetic patients at different stages of CKD. In this population‐based cohort study, we compared the surgical outcome, readmission, and mortality rates after osteosynthesis of hip fractures in diabetic patients with different stages of renal function. Diabetic patients who received primary osteosynthesis for hip fracture between January 1997 and December 2013 were enrolled. The primary outcomes were surgical outcomes, including infection and revision surgery. The secondary outcomes were all‐cause readmission and mortality. This study included 44,065 patients; 11,954 had CKD (diabetic CKD group), 1662 patients were receiving dialysis (diabetic dialysis group), and 30,449 patients had no CKD (diabetic non‐CKD group). We found that the diabetic dialysis group had a significantly higher risk of infection and revision surgery compared with diabetic non‐CKD patients (HR = 1.52, 95% CI, 1.24 to 1.87; HR = 1.62, 95% CI, 1.33 to 1.97, respectively, both P < 0.001) and diabetic CKD patients (HR = 1.62, 95% CI, 1.32 to 1.99; HR = 1.48, 95% CI, 1.22 to 1.80, respectively, both P < 0.001). Diabetic CKD patients had a comparable risk of surgical complications including infection and revision as diabetic non‐CKD patients. For readmission and mortality, the diabetic dialysis group had the highest risk among the three groups at all time‐points (3 months after surgery, 1 year, and the last follow‐up, all P < 0.001). Compared with the diabetic non‐CKD group, the diabetic CKD group had an elevated risk of readmission and mortality at all time‐points (all P < 0.001). In conclusion, CKD was associated with worse outcomes after hip fracture fixation surgery. Although at significantly higher risk of readmission and mortality, CKD patients still had a comparable risk of infection and revision to non‐CKD patients. © 2019 American Society for Bone and Mineral Research.

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Concordance between Patient Self-Reports and Claims Data on Clinical Diagnoses, Medication Use, and Health System Utilization in Taiwan

Cited by 230 publications

References 25 publications

Disease-Modifying Therapies and Adherence in Multiple Sclerosis: Comparing Patient Self-Report with Pharmacy Records

Disease-Modifying Therapies and Adherence in Multiple Sclerosis: Comparing Patient Self-Report with Pharmacy Records

Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA

Chronic Kidney Disease Worsens Health Outcomes in Diabetic Patients After Hip Fracture Surgery: An Asian Nationwide Population-Based Cohort Study

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