How well does patient self-report predict asthma medication possession? Implications for medication reconciliation and adherence assessment.
BACKGROUND
Self-report is the most commonly used method for collecting information regarding asthma medication possession and adherence in clinical practice.


OBJECTIVE
To determine the agreement between self-report and pharmacy claims data for asthma medication possession.


METHODS
This is a retrospective study that examined pharmacy claims data 12 months before and after participants completed a structured asthma survey. This study was performed in a sample of health care workers and dependents >17 years old in a large, self-insured Midwestern United States health care center. The main outcome measure was agreement (kappa calculation) between self-report and pharmacy claims data of asthma medication possession.


RESULTS
Self-report of asthma medication use agreed moderately with pharmacy claims data for short-acting albuterol (κ=0.47 ± 0.03), salmeterol (κ=0.79 ± 0.04), and montelukast (κ=0.69 ± 0.03) but only slightly for inhaled corticosteroids (κ=0.18 ± 0.03) and prednisone (κ=0.10 ± 0.03) (n=1050 respondents). Both under self-reporting and over self-reporting were common with inhaled corticosteroids (14.4% and 23.1%, respectively) and varied significantly by specific drug type.


CONCLUSIONS
Self-report moderately agrees with asthma medication possession for most adult asthma patients, though the agreement differs considerably between and within asthma medication classes.
Lim
Kaiser G
KG
Division of Pulmonary Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Rank
Matthew A
MA
Li
James T C
JT
Patel
Ashok
A
Volcheck
Gerald W
GW
Branda
Megan E
ME
Cabanela
Rosa
R
Naessens
James M
JM
Shah
Nilay D
ND
Wagie
Amy
A
Beebe
Timothy
T
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006282:Health Personnel; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015146:Midwestern United States; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
D018927:Anti-Asthmatic Agents