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Agreement between self-reported morbidity and pharmacy claims data for prescribed medications in an older community based population.

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journal contribution
posted on 2021-04-01, 13:25 authored by Clionadh Mannion, John E. HughesJohn E. Hughes, Frank MoriartyFrank Moriarty, Kathleen BennettKathleen Bennett, Caitriona CahirCaitriona Cahir

Background: Studies have indicated variability around prevalence estimates of multimorbidity due to poor consensus regarding its definition and measurement. Medication-based measures of morbidity may be valuable resources in the primary-care setting where access to medical data can be limited. We compare the agreement between patient self-reported and medication-based morbidity; and examine potential patient-level predictors of discordance between these two measures of morbidity in an older (≥ 50 years) community-based population.

Methods: A retrospective cohort study was performed using national pharmacy claims data linked to The Irish LongituDinal study on Ageing (TILDA). Morbidity was measured by patient self-report (TILDA) and two medication-based measures, the Rx-Risk (< 65 years) and Rx-Risk-V (≥65 years), which classify drug claims into chronic disease classes. The kappa statistic measured agreement between self-reported and medication-based morbidity at the individual patient-level. Multivariate logistic regression was used to examine patient-level characteristics associated with discordance between measures of morbidity.

Results: Two thousand nine hundred twenty-five patients were included (< 65 years: N = 1095, 37.44%; and ≥ 65 years: N = 1830 62.56%). Hypertension and high cholesterol were the most prevalent self-reported morbidities in both age cohorts. Agreement was good or very good (κ = 0.61-0.81) for diabetes, osteoporosis and glaucoma; and moderate for high cholesterol, asthma, Parkinson's and angina (κ = 0.44-0.56). All other conditions had fair or poor agreement. Age, gender, marital status, education, poor-delayed recall, depression and polypharmacy were significantly associated with discordance between morbidity measures.

Conclusions: Most conditions achieved only moderate or fair agreement between self-reported and medication-based morbidity. In order to improve the accuracy in prevalence estimates of multimorbidity, multiple measures of multimorbidity may be necessary. Future research should update the current Rx-Risk algorithms in-line with current treatment guidelines, and re-assess the feasibility of using these indices alone, or in combination with other methods, to yield more accurate estimates of multimorbidity.


HRB Research Leader award (RL-2015-1579)

Department of Health and Children

The Atlantic Philanthropies

Irish Life



The original article is available at https://bmcgeriatr.biomedcentral.com

Published Citation

Mannion C, Hughes J, Moriarty F, Bennett K, Cahir C. Agreement between self-reported morbidity and pharmacy claims data for prescribed medications in an older community based population. BMC Geriatrics. 2020;20(1):283.

Publication Date

10 August 2020

PubMed ID



  • General Practice
  • HRB Centre for Primary Care Research
  • Data Science Centre

Research Area

  • Population Health and Health Services
  • Cancer


BioMed Central


  • Published Version (Version of Record)