In:
eGEMs (Generating Evidence & Methods to improve patient outcomes), Ubiquity Press, Ltd., Vol. 7, No. 1 ( 2019-04-12), p. 11-
Abstract:
Researchers often use prescribing data from electronic health records (EHR) or
dispensing data from medication or medical claims to determine medication utilization. However, neither source has complete information on medication use. We compared antibiotic prescribing and dispensing records for 200,395 patients in the National
Patient-Centered Clinical Research Network (PCORnet) Antibiotics and Childhood Growth Study. We stratified analyses by delivery system type [closed integrated (cIDS) and
non-cIDS] ; 90.5 percent and 39.4 percent of prescribing records had matching dispensing
records, and 92.7 percent and 64.0 percent of dispensing records had matching prescribing records at cIDS and non-cIDS, respectively. Most of the dispensings without
a matching prescription did not have same-day encounters in the EHR, suggesting they were medications given outside the institution providing data, such as those from urgent
care or retail clinics. The sensitivity of prescriptions in the EHR, using dispensings as a gold standard, was 99.1 percent and 89.9 percent for cIDS and non-cIDS,
respectively. Only 0.7 percent and 6.1 percent of patients at cIDS and non-cIDS, respectively, were classified as false-negative, i.e. entirely unexposed to antibiotics
when they in fact had dispensings. These patients were more likely to have a complex chronic condition or asthma. Overall, prescription records worked well to identify
exposure to antibiotics. EHR data, such as the data available in PCORnet, is a unique and vital resource for clinical research. Closing data gaps by understanding why
prescriptions may not be captured can improve this type of data, making it more robust for observational research.
Type of Medium:
Online Resource
ISSN:
2327-9214
DOI:
10.5334/egems.274.s1
Language:
Unknown
Publisher:
Ubiquity Press, Ltd.
Publication Date:
2019
detail.hit.zdb_id:
2734659-6
