title: Pharmacy data for tuberculosis surveillance and assessment of patient management.
abstract: 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.
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. deborah.yokoe@channing.harvard.edu
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Yokoe
authors.forename: Steven W
authors.initials: SW
authors.lastname: Coon
authors.forename: Rachel
authors.initials: R
authors.lastname: Dokholyan
authors.forename: Michael C
authors.initials: MC
authors.lastname: Iannuzzi
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
authors.forename: Sarah
authors.initials: S
authors.lastname: Meredith
authors.forename: Marisa
authors.initials: M
authors.lastname: Moore
authors.forename: Lynelle
authors.initials: L
authors.lastname: Phillips
authors.forename: Wayne
authors.initials: W
authors.lastname: Ray
authors.forename: Stephanie
authors.initials: S
authors.lastname: Schech
authors.forename: Deborah
authors.initials: D
authors.lastname: Shatin
authors.forename: Richard
authors.initials: R
authors.lastname: Platt
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents