Agreement between patients' self-report and physicians' prescriptions on cardiovascular drug exposure: the PGRx database experience

Pharmacoepidemiol Drug Saf. 2010 Jun;19(6):591-5. doi: 10.1002/pds.1952.

Abstract

Purpose: Patients' self-reported drug exposure is subjected to memory errors and different sources of bias. Utilization of prescription records is impaired with non-compliance and over-the-counter (OTC) drug utilization. This study compared patients' self-report (PS) to physician's prescriptions of cardiovascular drugs (CVDs).

Methods: The PGRx database is constituted by networks of specialized centers that recruited cases of 15 different diseases including myocardial infarction (MI) cases, and a network of general practitioners recruiting a pool of potential referents. For MI cases and referents, data on all drug utilization within the 2 years preceding the index date were obtained from PS and from physician's report of their prescriptions (PP). Patients' reports were obtained using a structured telephone interview complemented with an interview guide containing names of diseases and pictures of drug packages. Comparisons were made on exposure to each class of CVDs, for different time-windows, 2 months, 3-12 months and 13-24 months prior to the index date.

Results: The concordance between physician and patient report was assessed on 2702 patient-physician pairs. Agreement was excellent overall (kappa = 0.83, 95% confidence interval (CI): 0.81-0.85). Prevalences of exposure were very close between PS and PP for all classes of prescription CVDs.

Conclusion: Using a standardized and systematic collection of information on drug exposure directly from patients appeared to provide similar information to using physician prescription records over a 2-year recall period.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Databases, Factual
  • Female
  • Humans
  • Interviews as Topic / methods
  • Male
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Nonprescription Drugs / therapeutic use
  • Physicians, Family
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prospective Studies
  • Time Factors
  • Young Adult

Substances

  • Cardiovascular Agents
  • Nonprescription Drugs