Assessing the feasibility of using computerized pharmacy refill data to monitor antidepressant treatment on a population basis: a comparison of automated and self-report data.
This article compares self-report and automated data as measures of dose and duration of antidepressant use in order to assess the feasibility of using automated pharmacy data in a disease management context. We used self-report and computerized refill data to identify two treatment failures-premature discontinuation of the medication and sub-optimal dosages-at time points 1 and 4 months after initiation of antidepressant therapy. The sources showed modest agreement regarding identification of current users at 1 month (kappa = .33); agreement was high at 4 months (kappa = .72). Agreement regarding dosage adequacy was also higher later in treatment, with kappas of .52 and .65 at 1 and 4 months, respectively. The two sources showed high agreement on an overall measure of acute phase treatment adequacy (kappa = .80). Data completeness was another outcome, with data on current users and overall treatment adequacy generally available from computerized files, data on dose less so. Automated pharmacy data appear to be a feasible means of monitoring treatment adequacy and quality of care as part of a disease management approach to improving care for populations of patients.
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98101, USA.
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Saunders
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Simon
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Bush
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Grothaus
D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016303:Clinical Pharmacy Information Systems / Q000592:standards*; D019468:Disease Management; D016903:Drug Monitoring; D017723:Drug Utilization Review / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires / Q000592:standards*; D017211:Treatment Failure; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014861:Washington
D000928:Antidepressive Agents