How Well Does Patient Self-Report Predict Asthma Medication Possession? Implications for Medication Reconciliation and Adherence Assessment

Abstract

Background. Self-report is the most commonly used method for collecting information regarding asthma medication possession and adherence in clinical practice. Objective. To determine the agreement between self-report and pharmacy claims data for asthma medication possession. Methods. This is a retrospective study that examined pharmacy claims data 12 months before and after participants completed a structured asthma survey. This study was performed in a sample of health care workers and dependents >17 years old in a large, self-insured Midwestern United States health care center. The main outcome measure was agreement (kappa calculation) between self-report and pharmacy claims data of asthma medication possession. Results. Self-report of asthma medication use agreed moderately with pharmacy claims data for short-acting albuterol (κ = 0.47 ± 0.03), salmeterol (κ = 0.79 ± 0.04), and montelukast (κ = 0.69 ± 0.03) but only slightly for inhaled corticosteroids (κ = 0.18 ± 0.03) and prednisone (κ = 0.10 ± 0.03) (n = 1050 respondents). Both under self-reporting and over self-reporting were common with inhaled corticosteroids (14.4% and 23.1%, respectively) and varied significantly by specific drug type. Conclusions. Self-report moderately agrees with asthma medication possession for most adult asthma patients, though the agreement differs considerably between and within asthma medication classes.

• asthma
• self-report
• medication possession
• medication adherence
• medication reconciliation
• asthma education
• inhaled corticosteroids
• short-acting bronchodilators

Acknowledgments

This work was funded by a grant from the Department of Medicine, Mayo Clinic, Rochester, Minnesota.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.