Agreement between Medicare pharmacy claims, self-report, and medication inventory for assessing lipid-lowering medication use.

Academic Article

Abstract

  • BACKGROUND: Medicare claims have been used to study lipid-lowering medication (LLM) use among US adults. METHODS: 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). RESULTS: 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]). CONCLUSIONS: 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.
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    Keywords

  • Medicare Part D, drug, drug prescriptions, hydroxymethylglutaryl-CoA reductase inhibitors, insurance claim review, pharmacoepidemiology, utilization, African Americans, Aged, Aged, 80 and over, Databases, Factual, European Continental Ancestry Group, Female, Humans, Hypolipidemic Agents, Male, Medicare, Pharmacoepidemiology, Self Report, Sex Factors, United States
  • Digital Object Identifier (doi)

    Author List

  • Colantonio LD; Kent ST; Kilgore ML; Delzell E; Curtis JR; Howard G; Safford MM; Muntner P
  • Start Page

  • 827
  • End Page

  • 835
  • Volume

  • 25
  • Issue

  • 7