Pharmacy data for tuberculosis surveillance and assessment of patient management.
Underreporting tuberculosis (TB) cases can compromise surveillance. We evaluated the contribution of pharmacy data in three different managed-care settings and geographic areas. Persons with more than two anti-TB medications were identified by using pharmacy databases. Active TB was confirmed by using state TB registries, medical record review, or questionnaires from prescribing physicians. We identified 207 active TB cases, including 13 (6%) missed by traditional surveillance. Pharmacy screening identified 80% of persons with TB who had received their medications through health plan-reimbursed sources, but missed those treated solely in public health clinics. The positive predictive value of receiving more than two anti-TB medications was 33%. Pharmacy data also provided useful information about physicians' management of TB and patients' adherence to prescribed therapy. Pharmacy data can help public health officials to find TB cases and assess their management in populations that receive care in the private sector.
Yokoe
Deborah S
DS
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. deborah.yokoe@channing.harvard.edu
Coon
Steven W
SW
Dokholyan
Rachel
R
Iannuzzi
Michael C
MC
Jones
Timothy F
TF
Meredith
Sarah
S
Moore
Marisa
M
Phillips
Lynelle
L
Ray
Wayne
W
Schech
Stephanie
S
Shatin
Deborah
D
Platt
Richard
R
D000995:Antitubercular Agents / Q000627:therapeutic use*; D006279:Health Maintenance Organizations; D006801:Humans; D016347:Medical Records Systems, Computerized; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010349:Patient Compliance; D010594:Pharmacies; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents