title: Agreement between administrative data and the Resident Assessment Instrument Minimum Dataset (RAI-MDS) for medication use in long-term care facilities: a population-based study.
abstract: BACKGROUND
  Prescription medication use, which is common among long-term care facility (LTCF) residents, is routinely used to describe quality of care and predict health outcomes. Data sources that capture medication information, which include surveys, medical charts, administrative health databases, and clinical assessment records, may not collect concordant information, which can result in comparable prevalence and effect size estimates. The purpose of this research was to estimate agreement between two population-based electronic data sources for measuring use of several medication classes among LTCF residents: outpatient prescription drug administrative data and the Resident Assessment Instrument Minimum Data Set (RAI-MDS) Version 2.0.
  
  
  METHODS
  Prescription drug and RAI-MDS data from the province of Saskatchewan, Canada (population 1.1 million) were linked for 2010/11 in this cross-sectional study. Agreement for anti-psychotic, anti-depressant, and anti-anxiety/hypnotic medication classes was examined using prevalence estimates, Cohen's κ, and positive and negative agreement. Mixed-effects logistic regression models tested resident and facility characteristics associated with disagreement.
  
  
  RESULTS
  The cohort was comprised of 8,866 LTCF residents. In the RAI-MDS data, prevalence of anti-psychotics was 35.7%, while for anti-depressants it was 37.9% and for hypnotics it was 27.1%. Prevalence was similar in prescription drug data for anti-psychotics and anti-depressants, but lower for hypnotics (18.0%). Cohen's κ ranged from 0.39 to 0.85 and was highest for the first two medication classes. Diagnosis of a mood disorder and facility affiliation was associated with disagreement for hypnotics.
  
  
  CONCLUSIONS
  Agreement between prescription drug administrative data and RAI-MDS assessment data was influenced by the type of medication class, as well as selected patient and facility characteristics. Researchers should carefully consider the purpose of their study, whether it is to capture medication that are dispensed or medications that are currently used by residents, when selecting a data source for research on LTCF populations.
authors.affiliation: University of Manitoba, Winnipeg, MB, Canada. lisa.lix@umanitoba.ca.|University of Saskatchewan, Saskatoon, SK, Canada. lisa.lix@umanitoba.ca.|Health Quality Council, Saskatoon, SK, Canada. lisa.lix@umanitoba.ca.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lix
authors.affiliation: University of Manitoba, Winnipeg, MB, Canada. lin.yan@umanitoba.ca.
authors.forename: Lin
authors.initials: L
authors.lastname: Yan
authors.affiliation: University of Saskatchewan, Saskatoon, SK, Canada. d.blackburn@usask.ca.
authors.forename: David
authors.initials: D
authors.lastname: Blackburn
authors.affiliation: Health Quality Council, Saskatoon, SK, Canada. nhu@hqc.sk.ca.
authors.forename: Nianping
authors.initials: N
authors.lastname: Hu
authors.affiliation: Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. Verena.Schneider-Lindner@medma.uni-heidelberg.de.
authors.forename: Verena
authors.initials: V
authors.lastname: Schneider-Lindner
authors.affiliation: University of Saskatchewan, Saskatoon, SK, Canada. yvonne.shevchuk@usask.ca.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Shevchuk
authors.affiliation: University of Saskatchewan, Saskatoon, SK, Canada. gteare@hqc.sk.ca.|Health Quality Council, Saskatoon, SK, Canada. gteare@hqc.sk.ca.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Teare
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D006801:Humans; D008134:Long-Term Care; D009735:Nursing Homes; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D011619:Psychotropic Drugs