Agreement between administrative data and the Resident Assessment Instrument Minimum Dataset (RAI-MDS) for medication use in long-term care facilities: a population-based study

BMC Geriatrics

Gary F Teare²  Yvonne Shevchuk¹  Verena Schneider-Lindner⁴  Nianping Hu²  David Blackburn¹  Lin Yan³  Lisa M Lix² 

[1] University of Saskatchewan, Saskatoon, SK, Canada;Health Quality Council, Saskatoon, SK, Canada;University of Manitoba, Winnipeg, MB, Canada;Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany

关键词: Mental health;    Electronic database;    Medication system;    Long-term care;    Concordance;   

Others  :  1137413
DOI  :  10.1186/s12877-015-0023-2

 received in 2014-10-09, accepted in 2015-02-25,  发布年份 2015

【 摘 要 】

Background

Prescription medication use, which is common among long-term care facility (LTCF) residents, is routinely used to describe quality of care and predict health outcomes. Data sources that capture medication information, which include surveys, medical charts, administrative health databases, and clinical assessment records, may not collect concordant information, which can result in comparable prevalence and effect size estimates. The purpose of this research was to estimate agreement between two population-based electronic data sources for measuring use of several medication classes among LTCF residents: outpatient prescription drug administrative data and the Resident Assessment Instrument Minimum Data Set (RAI-MDS) Version 2.0.

Methods

Prescription drug and RAI-MDS data from the province of Saskatchewan, Canada (population 1.1 million) were linked for 2010/11 in this cross-sectional study. Agreement for anti-psychotic, anti-depressant, and anti-anxiety/hypnotic medication classes was examined using prevalence estimates, Cohen’s κ, and positive and negative agreement. Mixed-effects logistic regression models tested resident and facility characteristics associated with disagreement.

Results

The cohort was comprised of 8,866 LTCF residents. In the RAI-MDS data, prevalence of anti-psychotics was 35.7%, while for anti-depressants it was 37.9% and for hypnotics it was 27.1%. Prevalence was similar in prescription drug data for anti-psychotics and anti-depressants, but lower for hypnotics (18.0%). Cohen’s κ ranged from 0.39 to 0.85 and was highest for the first two medication classes. Diagnosis of a mood disorder and facility affiliation was associated with disagreement for hypnotics.

Conclusions

Agreement between prescription drug administrative data and RAI-MDS assessment data was influenced by the type of medication class, as well as selected patient and facility characteristics. Researchers should carefully consider the purpose of their study, whether it is to capture medication that are dispensed or medications that are currently used by residents, when selecting a data source for research on LTCF populations.

【 授权许可】

   
2015 Lix et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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