title: Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.
abstract: Medicare claims have been used to study lipid-lowering medication (LLM) use among US adults.
  
  
  
  We analyzed the agreement between Medicare claims for LLM and LLM use indicated by self-report during a telephone interview and, separately, by a medication inventory performed during an in-home study visit upon enrollment into the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. We included REGARDS participants ≥65 years enrolled in 2006-2007 with Medicare pharmacy benefits (Part D) from 120 days before their telephone interview through their medication inventory (n = 899).
  
  
  
  Overall, 39.2% and 39.5% of participants had a Medicare claim for an LLM within 120 days prior to their interview and medication inventory, respectively. Also, 42.7% of participants self-reported using LLMs, and 41.8% had an LLM in their medication inventory. The Kappa statistic (95% confidence interval [CI]) for agreement of Medicare claims with self-report and medication inventory was 0.68 (0.63-0.73) and 0.72 (0.68-0.77), respectively. No Medicare claims for LLMs were present for 22.1% (95%CI: 18.1-26.6%) of participants who self-reported taking LLMs and 18.9% (15.1-23.3%) with LLMs in their medication inventory. Agreement between Medicare claims and self-report was lower among Black male individuals (Kappa = 0.34 [95%CI: 0.14-0.54]) compared with Black female individuals (0.70 [0.61-0.79]), White male individuals (0.65 [0.56-0.75]), and White female individuals (0.79 [0.72-0.86]). Agreement between Medicare claims and the medication inventory was also low among Black male individuals (Kappa = 0.48 [95%CI: 0.29-0.66]).
  
  
  
  Although substantial agreement exists, many Medicare beneficiaries who self-report LLM use or have LLMs in a medication inventory have no claims for these medications. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Lisandro D
authors.initials: LD
authors.lastname: Colantonio
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Shia T
authors.initials: ST
authors.lastname: Kent
authors.affiliation: Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Kilgore
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Delzell
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.|Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Curtis
authors.affiliation: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: George
authors.initials: G
authors.lastname: Howard
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Monika M
authors.initials: MM
authors.lastname: Safford
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.|Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D017891:Pharmacoepidemiology / Q000379:methods*; D057566:Self Report; D012737:Sex Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data
chemical_list: D000960:Hypolipidemic Agents
keywords: Medicare Part D; drug; drug prescriptions; hydroxymethylglutaryl-CoA reductase inhibitors; insurance claim review; pharmacoepidemiology; utilization
references.citation: Am J Cardiol. 2013 Sep 1;112(5):664-70
references.pmid: 23726177
references.citation: Health Rep. 2013 Jan;24(1):3-9
references.pmid: 24259111
references.citation: J Am Geriatr Soc. 2013 Feb;61(2):309-10
references.pmid: 23405936
references.citation: Neuroepidemiology. 2005;25(3):135-43
references.pmid: 15990444
references.citation: J Manag Care Pharm. 2012 Nov-Dec;18(9):690-700
references.pmid: 23206212
references.citation: Pharmacoepidemiol Drug Saf. 2013 Aug;22(8):899-906
references.pmid: 23696101
references.citation: BMC Med Res Methodol. 2003 Oct 20;3:21
references.pmid: 14567763
references.citation: Med Care. 2015 May;53(5):463-70
references.pmid: 25793271
references.citation: J Clin Epidemiol. 1994 Feb;47(2):183-9
references.pmid: 8113827
references.citation: Health Aff (Millwood). 2014 Nov;33(11):2012-7
references.pmid: 25367997
references.citation: Pharmacoepidemiol Drug Saf. 2006 Oct;15(10):710-8
references.pmid: 16498575
references.citation: Pharmacoepidemiol Drug Saf. 2013 Jan;22(1):55-63
references.pmid: 23135758
references.citation: Ann Pharmacother. 2008 Sep;42(9):1208-15
references.pmid: 18648016
references.citation: N Engl J Med. 2014 Apr 10;370(15):1422-31
references.pmid: 24645848
references.citation: J Hypertens. 2015 Feb;33(2):412-20
references.pmid: 25304468
references.citation: Circulation. 2014 Jun 24;129(25 Suppl 2):S1-45
references.pmid: 24222016
references.citation: J Clin Epidemiol. 2013 Nov;66(11):1308-16
references.pmid: 23968693
references.citation: Drugs Aging. 2008;25(1):71-80
references.pmid: 18184031
references.citation: Am J Epidemiol. 2012 Apr 1;175(7):597-601
references.pmid: 22415032
references.citation: Am J Manag Care. 2014 Sep;20(9):743-8
references.pmid: 25365749
references.citation: Ann Intern Med. 2013 Jul 16;159(2):105-14
references.pmid: 23752663
references.citation: J Gen Intern Med. 2013 Jul;28(7):860-1
references.pmid: 23539284
references.citation: Am J Manag Care. 2014 Feb;20(2):146-50
references.pmid: 24738532
references.citation: Epidemiology. 1990 Mar;1(2):98-100
references.pmid: 2073512
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: Br J Clin Pharmacol. 1998 Jun;45(6):591-5
references.pmid: 9663815
references.citation: J Clin Epidemiol. 1997 May;50(5):619-25
references.pmid: 9180655
references.citation: Med Care. 1986 Jan;24(1):67-74
references.pmid: 3945130
references.citation: Pharmacoepidemiol Drug Saf. 2007 Sep;16(9):961-8
references.pmid: 17654746
references.citation: Am J Epidemiol. 2016 Oct 1;184(7):532-544
references.pmid: 27651383
references.citation: J Clin Epidemiol. 2005 Apr;58(4):323-37
references.pmid: 15862718
references.citation: Fed Regist. 1991 Aug 12;56(155):38074-82
references.pmid: 10170805
references.citation: Am J Epidemiol. 2005 Aug 1;162(3):199-200
references.pmid: 15987728