Use of computerized health claims data to monitor compliance with antibiotic prophylaxis in sickle cell disease.
OBJECTIVE
To demonstrate how computerized claims data can be used to identify children with sickle cell disease probably having low compliance with antibiotic prophylaxis of pneumococcal disease.


METHODS
The study included under-5-year-old children with sickle cell disease who were on antibiotic prophylaxis and covered by Medicaid in Michigan (N=158), Missouri (N=64), and New York (N=297). Medicaid pharmacy claims from 10-month periods were used to estimate the total days' supply of antibiotics dispensed for each child. Low compliance was defined as a ratio less than 0.33 for the child's estimated total days' supply of antibiotics divided by days in the child's study period. Two slightly different methods of estimating antibiotic supplies were used to generate a low and high estimate of the percentage of children having low compliance.


RESULTS
Low and high estimates of the percentage of children having low compliance were 20% and 25% in Michigan, 19% and 31% in Missouri, and 16% and 24% in New York. With each method of estimating antibiotic supplies, low compliance was not associated with age in any state.


CONCLUSIONS
Computerized claims data can be used, potentially by Medicaid programs and managed care organizations, to identify children with sickle cell disease who probably have low compliance with antibiotic prophylaxis.
Davis
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Office of Epidemiology and Biostatistics, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville, Maryland 20857, USA. davisha@cder.fda.gov