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Measuring oral contraceptive adherence using self-report versus pharmacy claims data.

ABSTRACT: OBJECTIVE:Proportion of Days Covered (PDC) is a measure of medication adherence that uses prescription claims data to describe the proportion of days that the patient possessed medication. The objective of this study is to compare PDC and self-report as measures of oral contraceptive pills (OCPs) adherence and to identify individual-level predictors of adherence. STUDY DESIGN:In a sample of 384 OCP users, self-report was compared with PDC as measures of adherence over the past 3 months. Patient-level variables were examined for associations with adherence using multivariable logistic regression models. RESULTS:High adherence, defined as missing ?1 pill per month, was 76%, 68% and 54% as measured by self-report, PDC and both measures, respectively. Younger women (ages 18-25 and 26-33 years) were significantly less likely to have high adherence on both measures than women in the 34-40 age group [adjusted odds ratio (OR) 0.20, 95% confidence interval (CI) 0.08-0.51 and adjusted OR 0.26, 95% CI 0.11-0.62, respectively). Other predictors of high adherence on both self-report and PDC measures included being in a relationship (adjusted OR 2.30, 95% CI 1.14-4.64, compared with unpartnered women), Protestant religion (adjusted OR 2.08, 95% CI 1.07-4.06, compared with women with no religious affiliation) and higher contraceptive self-efficacy (adjusted OR 1.63, 95% CI 1.03-2.58). CONCLUSION:PDC derived from pharmacy claims, or a combination of PDC and self-report measures, may be an alternative to self-report alone for measuring OCP adherence. IMPLICATIONS:PDC may be a potential tool for measuring women's adherence to OCPs and should be validated in future studies.

SUBMITTER: Nelson HN

PROVIDER: S-EPMC6540974 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Measuring oral contraceptive adherence using self-report versus pharmacy claims data.

Nelson Hallie N HN Borrero Sonya S Lehman Erik E Velott Diana L DL Chuang Cynthia H CH

Contraception 20170904 6

<h4>Objective</h4>Proportion of Days Covered (PDC) is a measure of medication adherence that uses prescription claims data to describe the proportion of days that the patient possessed medication. The objective of this study is to compare PDC and self-report as measures of oral contraceptive pills (OCPs) adherence and to identify individual-level predictors of adherence.<h4>Study design</h4>In a sample of 384 OCP users, self-report was compared with PDC as measures of adherence over the past 3 m ...[more]

PMID: 28882679

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Project description:ObjectivesIndicators of guideline adherence are frequently used to examine the appropriateness of healthcare services. Only some potential indicators are actually usable for research with routine administrative claims data, potentially leading to a biased selection of research questions. This study aimed at developing a systematic approach to extract potential indicators from clinical practice guidelines (CPG), evaluate their feasibility for research with claims data and assess how the extracted set reflected different types of healthcare services. Diabetes mellitus (DM), Swiss national guidelines and health insurance claims data were analysed as a model case.MethodsCPG for diabetes patients were retrieved from the Swiss Endocrinology and Diabetes Society website. Recommendation statements involving a specific healthcare intervention for a defined patient population were translated into indicators of guideline adherence. Indicators were classified according to disease stage and healthcare service type. We assessed for all indicators whether they could be analysed with Swiss mandatory health insurance administrative claims data.ResultsA total of 93 indicators were derived from 15 CPG, representing all sectors of diabetes care. For 63 indicators, the target population could not be identified using claims data only. For 67 indicators, the intervention could not be identified. Nine (10%) of all indicators were feasible for research with claims data (three addressed gestational diabetes and screening, five screening for complications and one glucose measurement). Some types of healthcare services, eg, management of risk factors, treatment of the disease and secondary prevention, lacked corresponding indicators feasible for research.ConclusionsOur systematic approach could identify a number of indicators of healthcare service utilisation, feasible for DM research with Swiss claims data. Some areas of healthcare were covered less well. The approach could be applied to other diseases and countries, helping to identify the potential bias in the selection of indicators and optimise research.

Dataset Information

Measuring oral contraceptive adherence using self-report versus pharmacy claims data.

Publications

Measuring oral contraceptive adherence using self-report versus pharmacy claims data.

Similar Datasets

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