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American Journal of Epidemiology Vol. 142, No. 10: 1103-1112
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health


other

Recall Accuracy for Prescription Medications: Self-report Compared with Database Information

Suzanne L West1, David A. Savitz1, Gary Koch2, Brian L. Strom3, Harry A. Guess1 and Abraham Hartzema4

1Department of Epidemiology, School of Public Health, University of North Carolina Chapel Hill, NC
2Department of Biostatistics, School of Public Health, University of North Carolina Chapel Hill, NC
3Center for Clinical Epidemiology and Biostatistics and Division of General Internal Medicine, School of Medicine, University of Pennsylvania Philadelphia, PA
4Division of Pharmaceutical Policy and Evaluative Sciences, School of Pharmacy, University of North Carolina Chapel Hill, NC

A methodological study was performed in 1992 to evaluate the accuracy of self-reported use of nonsteroidal antiinflammatory drugs (NSAIDs) and noncontraceptive estrogens that had been dispensed during the previous 12 years. A sample of 560 individuals dispensed NSAIDs or estrogens, and 140 individuals without NSAID/estrogen dispensations were selected from the Group Health Cooperative pharmacy database. Demographic, behavioral, and drug information was ascertained by telephone interview for 356 persons with and 98 persons without NSAID/estrogen dispensations. Of those with only a single NSAID dispensation, 41% (95% confidence interval (Cl) 32–50%) were able to recall any NSAJD use compared with 85%(95% Cl 76–94%) for those with multiple NSAID dispensations. Thirty percent (95% Cl 24–36%) recalled the NSAID name, and 15% (95% Cl 10 –20%) recalled both the name and dose. For estrogens, 78% (95%Cl 70–86%) recalled the name, but only 26% (95%Cl 17–34%) recalled the name and dose. Age, but not sex, appeared to influence recall accuracy: Persons 50–65 years of age recalled the NSAID name more accurately than those aged 66–80 (odds ratio (OR) = 1.8, 95% confidence interval (CO 1.0–3.4). A similar advantage was noted for 50- to 65-year-old women in recalling the estrogen name (OR = 1.5, 95% Cl 0.6–3.9). Drug name was recalled more frequently for exposures stopped 2–3 years prior to interview than for those stopped 7–11 years prior (OR =3.0, 95%Cl 1.6–5.7, and OR = 2.4, 95%Cl 0.9–6.7, for NSAIDs and estrogens, respectively). Specificity was consistently high, ranging from 92%to 100%. This study suggests significant underascertainment of self-reported prescription drug exposure but little evidence that exposures are overreported. Am J Epidemiol 1995;142:1103–12.

drugs; epidemiologic methods; questionnaires; recall; reproducibility of results


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