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Am J Epidemiol 2004; 159:308-317.
Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health


PRACTICE OF EPIDEMIOLOGY

A Validation Study of Patient Interview Data and Pharmacy Records for Antihypertensive, Statin, and Antidepressant Medication Use among Older Women

Denise M. Boudreau1,2 , Janet R. Daling3,4, Kathleen E. Malone3,4, Jacqueline S. Gardner2, David K. Blough2 and Susan R. Heckbert1,2,4

1 Center for Health Studies, Group Health Cooperative, Seattle, WA.
2 Department of Pharmacy, University of Washington, Seattle, WA.
3 Fred Hutchinson Cancer Research Center, Seattle, WA.
4 Department of Epidemiology, University of Washington, Seattle, WA.

A validation study evaluated the accuracy of self-reported use of commonly used medications among older women. Within a case-control study of breast cancer, drug information was ascertained by interview. Pharmacy records from 1990 to 1999 were obtained from a Washington State health maintenance organization (66% of subjects) and retail pharmacies (34% of subjects) on a sample of subjects (212 cases, 191 controls) and used as the "gold standard." Recall accuracy was assessed for 6-month, 2-year, and 8-year time windows. Sensitivity of antihypertensive use was 92% (95% confidence interval (CI): 85, 96) for cases and controls in the 6-month period and slightly lower for the 2-year (90% (95% CI: 82, 94) and 87% (95% CI: 78, 92)) and 8-year (80% (95% CI: 69, 88) and 79% (95% CI: 68, 88)) periods. For statins, sensitivity was 83% (95% CI: 64, 93) for cases and 93% (95% CI: 69, 99) for controls in the 6-month period, 75% (95% CI: 55, 88) and 86% (95% CI: 60, 96) in the 2-year period, and 67% (95% CI: 42, 85) and 75% (95% CI: 41, 93) in the 8-year period. For self-report of antidepressants, sensitivities ranged from 66% (95% CI: 47, 80) in the 6-month period to 44% (95% CI: 30, 60) in the 8-year period. Specificity was high among all drug classes, ranging from 91% to 100%. Recall did not differ by case-control status. Trivial changes in estimates were observed when health maintenance organization records alone were used as the gold standard. Self-reported use of antihypertensives and statins appears to be relatively accurate among older women.

antidepressive agents; antihypertensive agents; hydroxymethylglutaryl-CoA reductase inhibitors; interviews; validation studies [publication type]; women

Abbreviations: Abbreviations: CI, confidence interval; GHC, Group Health Cooperative.


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