Self-reported Medicine Use Research Articles

Are self-reported medical conditions and medicine use from middle-aged and older adults credible? A validation study comparing Danish SHARE-data with National Health Register data

Self-reported information on medical conditions and medicine use is widely used in epidemiological research. We investigated the validity of self-reported medical conditions and medicine use from Danish participants in the Survey of Health, Ageing and Retirement in Europe. Self-reported health data were linked at individual level with the National Patient Registry and the Danish National Prescription Registry (n=5572). Agreement was assessed by kappavalue and presented as sensitivity, specificity, predictive values, and odds ratios. The agreement of self-reported medical conditions varied by type (κ=0.23-0.67), lowest for cholesterol-related diseases,highest for diabetes. Self-reported medicine use varied by medication type (κ=0.33-0.90) lowest for painkillers, highest for diabetes. Women had lower odds for self-reporting medicine use correctlybut higher odds for self-reported diseases. Higher age was associated with lower agreement, while higher education with higher agreement. Although Danish data from the Survey of Health, Ageing and Retirement in Europe on medical conditions and medicine vary, the data are valid for epidemiological use for most medicine data, and for diseases associated with hospitalizations or influencing everyday life.Caution is warranted for self-reported data from 70+ year olds and people with lower educational level.

Migrant Differences in Adolescents’ Medicine Use for Common Health Problems: A National Representative Survey

Aim: Despite the substantial proportion of adolescents use medicine for common health problems, prevalence of medicine use among adolescents with migrant background have rarely been documented, and the causal pathway continue to be poorly understood. The aim was to examine whether there are migrant differences in adolescents’ medicine use for common health problems, and if feeling safe at school, as a non-exposure to discrimination, explained these differences. Methods: Data derived from the 2006 Danish contribution to the World Health Organization collaborative study Health Behaviour in School-aged Children (HBSC). Medicine use for headache, stomach-ache, difficulties getting to sleep and nervousness and feeling safe at school were self-reported. The population included boys and girls from ages 11 to 15 who were enrolled in the cross-sectional study. Included were 8480 ethnic Danes, 508 descendants and 456 migrants. Logistic regression was applied to assess associations. Multi-level logistic regression was used to assess the independent effect of school cluster. Results: Immigrant girls reported the highest past-month prevalence of medicine use for the four ailments included in the analysis. The highest prevalence of medicine use was found for alleviating headache (54.7%), followed by stomach-ache (30.4%). Among the boys who took medicine for stomach-ache, the odds were 2.11 (1.46-3.05) for descendants and 1.55 (1.00-2.39) for immigrants. Feeling safe at school modifies the effect by reducing the odds to 1.93 (1.32-2.81) for descendants and to 1.30 (0.81-2.07) for immigrants. When simultaneously controlling for the clustering effect of school, feeling safe at school and specific symptoms, the risk of using medicine for stomach-ache was still higher for descendant boys 1.90 (1.26-2.85). Conclusions: Self-reported medicine use for common health problems is high among adolescents with migrant background, particularly among first generations immigrant girls. Feeling safe at school partially mediated the association between migrant background and adolescent’s medicine use. As the process of migration is becoming more and more frequent, our findings suggest that more adolescents may be using medicines for reasons that cannot only be explained by frequency of symptoms alone.

Determining antenatal medicine exposures in South African women: a comparison of three methods of ascertainment

BackgroundIn the absence of clinical trials, data on the safety of medicine exposures in pregnancy are dependent on observational studies conducted after the agent has been licensed for use. This requires an accurate history of antenatal medicine use to determine potential risks. Medication use is commonly determined by self-report, clinician records, and electronic pharmacy data; different data sources may be more informative for different types of medication and resources may differ by setting. We compared three methods to determine antenatal medicine use (self-report, clinician records and electronic pharmacy dispensing records [EDR]) in women attending antenatal care at a primary care facility in Cape Town, South Africa in a setting with high HIV prevalence.MethodsStructured, interview-administered questionnaires recorded self-reported medicine use. Data were collected from clinician records and EDR on the same participants. We determined agreement between these data sources using Cohen’s kappa and, lacking a gold standard, used Latent Class Analysis to estimate sensitivity, specificity and positive predictive value (PPV) for each data source.ResultsBetween 55% and 89% of 967 women had any medicine use documented depending on the data source (median number of medicines/participant = 5 [IQR 3–6]). Agreement between the datasets was poor regardless of class except for antiretroviral therapy (ART; kappa 0.6–0.71). Overall, agreement was better between the EDR and self-report than with either dataset and the clinician records. Sensitivity and PPV were higher for self-report and the EDR and were similar for the two. Self-report was the best source for over-the-counter, traditional and complementary medicines; clinician records for vaccines and supplements; and EDR for chronic medicines.ConclusionsMedicine use in pregnancy was common and no single data source included all the medicines used. ART was the most consistently reported across all three datasets but otherwise agreement between them was poor and dependent on class. Using a single data collection method will under-estimate medicine use in pregnancy and the choice of data source should be guided by the class of the agents being investigated.

Association between noise annoyance and mental health outcomes - an evidence review

To date, most reviews on noise and mental health have focused on noise exposure. However, a number of studies found associations between mental health and noise annoyance, but not with exposure. A literature search was carried out in PubMed and Web of Science databases. We also hand-searched conference proceedings and references in other systematic reviews on noise exposure and annoyance/mental health. We identified 25 articles through the databases searches that satisfied the inclusion criteria; existing literature reviews provided two additional publications. The majority of identified studies used either a 5-point (n=15) or 11-point scale (n=5) to measure noise annoyance. The sources of noise annoyance mainly come from traffic (n=18 or 67%), and neighbourhood (n=4 or 15%). For mental health outcomes, 20 (74%), 2 (7%) and 2 (7%) articles used validated questionnaires, self-reported use of anxiolytics/antidepressants, or self-reported diagnosis of mental disease, respectively, to assess mental health. Six articles differentiated between depression and anxiety disorder while 19 focused on general mental health. Results from these studies overall point to an adverse association of noise annoyance (high noise annoyance in particular) with depression, anxiety or general mental problem, either measured by self-reported diagnosis, self-reported medicine use or questionnaires.

Discrepancy between electronic medicine list, pharmacy delivery and patient reported medicine intake in Greenland

ABSTRACT Medicine use is a cornerstone in the treatment of many conditions, but ill-use has the potential to harm the patient. Thus, accurate medication information is critical for patient care and safety. To investigate the association between participants’ reporting of using medicine daily, medicine list on Electronic Medical Record (EMR) and number of medicines handed out. Thirty-seven elderly Greenlanders were included, representing three different locations in Greenland. They were interviewed on daily medicine intake. Medicine list and pharmacy delivery were retrieved from the EMR. The difference between the number of drugs recorded in the EMR and the number delivered by pharmacy increased with number of drugs prescribed (p<0.0001). Thirty participants claimed that they were on daily medicine, and the EMR was in accordance with the delivered recorded by the pharmacy in just five participants. Eight had no registered medicine delivery. Four of seven, who claimed not being on daily medicine, were on daily medicine according to EMR. We found distinct discrepancies between EMR medicine list, medicine delivery by pharmacy and patient self-reported medicine use.

Pharmacokinetic Characterization to Enable Medicine Use in Pregnancy, the Potential Role of Physiologically-Based Pharmacokinetic Modeling: A Regulatory Perspective.

It is generally recommended that use of medicines should be avoided during pregnancy, sometimes however use of a medicine is essential to safeguard the health of mother and baby. A very limited number of medicines are however specifically licensed for use in pregnancy. This article considers the potential of PBPK modelling as a predictive tool to investigate the expected systemic exposure of medicines in pregnant women and to support possible dosing adjustment to maintain efficacy.

Antidepressant use and its relationship with current symptoms in a population-based sample of older Australians

BackgroundAustralia has the second highest per capita users of antidepressants globally, and their use is pronounced in older Australians. A better understanding of antidepressant use in older adults is important because the elderly are often prescribed multiple drugs, without review, for long periods. MethodsThis study analysed questionnaire data obtained from the Personality and Total Health through life project. Individual respondent data was linked to Pharmaceutical Benefits Scheme (PBS) records. Associations between self-reported medicine use and current symptoms with antidepressant dispensing were examined. Results1275 participants aged over 65 were included in the final analysis. One hundred and forty-six (11.5%) participants were dispensed an antidepressant within the specified timeframe. Of those, 38.4% self-reported that they use medicine for depression, 12.3% for anxiety, 17.8% for both depression and anxiety, 6.2% for sleep problems and 3.4% for pain. One fifth of those dispensed an antidepressant did not self-report use of the medicine. Being female or reporting symptoms of depression, anxiety or suicidality were significant predictors of being on an antidepressant. Increasing pain severity was also associated with increased likelihood of being on an antidepressant. LimitationsWe have presented a cross-sectional analysis, which can only provide associations between current symptoms and medicine use. We have only assessed respondents who received their scripts with PBS concession, which limits generalizability. ConclusionOur analysis highlights the high use of antidepressants in the elderly for various reasons. Our findings also uncovered a high amount of under-reporting of antidepressant use by respondents.

Persistent social inequality in medicine use for headache among adolescents in Denmark 1991-2014.

Socioeconomic variation in adolescents' medicine use behaviour is an understudied issue. To examine the association between socioeconomic background and medicine use for headache among adolescents, and how this association changes over time. Data stem from the Danish part of the international Health Behaviour in School-aged Children (HBSC) study 1991-2014 with data about parents' occupational social class (OSC) and self-reported medicine use for headache, n = 26,685. This study examined absolute social inequality (percent difference between high and low OSC) and relative social inequality (odds ratio for medicine use by OSC). In total, 40.5% used medicine for headache in the past month. There was a significant increase from 32.3% in 1991 to 42.8% in 2002 (test for trend, p < 0.0001) and very little change 2002-2014. This pattern was similar in high, middle and low OSC. The prevalence of medicine use for headache in high, middle and low OSC was 36.2%, 41.5% and 44.8% (p < 0.0001). The OR (95% CI) for medicine use was 1.25 (1.18-1.324) in middle and 1.43 (1.33-1.54) in low OSC. Medicine use for headache increased 1991-2002 and remained stable 2002-2014. There was increasing medicine use for headache with decreasing OSC; this social inequality was persistent 1991-2014.

Is self-rated health in adolescence a predictor of prescribed medication in adulthood? Findings from the Nord Trøndelag Health Study and the Norwegian Prescription Database

Self-rated health (SRH) is a commonly used health indicator predicting morbidity and mortality in a range of populations. However, the relationship between SRH and medication is not well established. The aim of this study was to examine adolescent SRH as a predictor for prescribed medication later in young adulthood. Eighteen years’ prospective data from the Nord-Trøndelag Health Study (HUNT) and the Norwegian Prescription Database (NorPD) were analyzed. Baseline data, gathered from 8982 adolescents (mean age 16.0 years) in the Young-HUNT I survey (1995–1997), were linked to individual data from NorPD, including information on all medications prescribed in 2013–2014. Gender-stratified negative binomial regression models were used to investigate the association between SRH and medication, also adjusted for age, baseline self-reported medicine use, physical and mental disability, smoking, and physical activity. Based on the Anatomical Therapeutic Chemical (ATC) Classification System, total consumption and consumption related to various ATC groups were examined.The adjusted analyses showed a dose–response relationship for females, with poorer SRH predicting higher average medication for both total consumption and for the ATC groups “Musculoskeletal system” (M), “Nervous system” (N; Analgesics (N02), Opioids (N02A)) and “Respiratiory system” (R). The predictive power of SRH, as well as the role of the adjustment factors, varies by gender and drug groups. This knowledge is important in order to identify risks for later disease and to capture pathological changes before and beyond the disease diagnosis, potentially preventing morbidity in the adult population.

Medicine use and disease control among adolescents with asthma.

Pharmacological treatment is a cornerstone in asthma management, but there is limited evidence on how adolescents use their medication and to what extent their asthma is under control. Therefore, the aim of this study was to compare self-reported and register-based medicine use in asthmatic adolescents. Furthermore, we investigated the association between medicine use, patient characteristics, and degree of asthma control. Cross-sectional analyses of 331 adolescents with asthma from a population-based birth cohort linked to data from the Swedish Prescribed Drug Register. Adolescents' asthma medicine use was assessed with three approaches: self-reported medicine use, self-reported use of someone else's medicines, and dispensed medicines from pharmacies during an 18-month period. Medicine use in adolescents with and without asthma control were compared. In total, 82% reported use of asthma medicines, 10 % reported use of someone else's medicines, and 62% were dispensed asthma medicines from pharmacies. Among adolescents with self-reported medicine use, 22% (n = 60) were neither dispensed medicines nor using someone else's medicines. The majority of those using someone else's medicines had also been dispensed asthma medicine (22 out of 33). Among adolescents with asthma, 176 were fully controlled and 155 were uncontrolled. Also, boys had higher odds of having asthma control than girls. Most adolescents with asthma reported use of asthma medicines, but a considerable proportion were neither dispensed any medicines nor using someone else's medicines. Girls were less likely to achieve asthma control. It is important to combine data sources to understand medicine use among adolescents with asthma.

Comparison of self-reported medicine use with the pharmaceutical claims database in patients with osteoarthritis

Comparison of self-reported medicine use with the pharmaceutical claims database in patients with osteoarthritis

Sense of Coherence and Medicine Use for Headache Among Adolescents

Objective To examine the association between headache, sense of coherence (SOC), and medicine use for headaches in a community-based sample of adolescents. Methods Epidemiological cross-sectional study, encompassing 20 out of 23 schools in the network of health-promoting schools in the county of South Jutland, Denmark. The study population consisted of students from seventh and ninth grade, participation rate 93%, n = 1393. The students answered questions on demographic variables, health behavior including medicine use, psychosocial health aspects, and sense of coherence, in an anonymous standardized questionnaire. The outcome measure was self-reported medicine use for headaches. The determinants were headache frequency and SOC measured by Wold and Torsheim's version for children of Antonovsky's 13-item SOC scale. Results Analyses adjusted for age group, family social class, exposure to bullying, and headache frequency showed increasing odds for medicine use for headaches (hereafter: medicine use) by decreasing SOC. There was no association between SOC and medicine use among students with a rare experience of headaches but a significant and graded association among students with at least weekly experience of headaches, that is, frequency of headaches modified the association between SOC and medicine use. Conclusions We found that adolescents with low SOC used medicine to cope with headaches to a greater extent than adolescents with high SOC.

Self‐rated health as predictor of medicine use in adolescence

To examine the association between self-rated health (SRH) and medicine use for four common complaints: headache, stomach-ache, difficulties in getting to sleep and nervousness, in a nationally representative sample of adolescents. The study population comprised of all students in the fifth, seventh and ninth grade (mean ages 11.6, 13.6 and 15.6 years) in a random sample of schools in Denmark 2002, participation rate 90.6%, n = 4.824. The students reported health problems, medicine use, social and psychosocial conditions in an anonymous and standardized questionnaire. The outcome measure was self-reported medicine use during the past month and the determinant was SRH measured by one item. There was an association between poor/fair SRH and medicine use for headache and stomach-ache. The associations remained statistically significant even after adjustment for frequency of the complaint for which the medicine was used: OR (95%CI) for medicine use for headache was 1.54 (1.10-2.14) among boys with poor/fair SRH and 1.50 (1.12-2.03) among girls with poor/fair SRH. A similar association was found between poor SRH and medicine use for stomach-ache for both boys (OR = 3.41 (2.09-5.55)) and girls (OR = 1.90 (1.36-2.67). Further, there was an association between poor/fair SRH and medicine use for difficulties in getting to sleep among girls, OR = 2.66 (1.26-5.63) but not among boys. There was no association between SRH and medicine use for nervousness. Poor/fair SRH is associated with medicine use for aches among Danish adolescents.

Is Victimization From Bullying Associated With Medicine Use Among Adolescents? A Nationally Representative Cross-sectional Survey in Denmark

The goal was to examine whether being a victim of bullying was associated with medicine use, taking into account the increased prevalence of physical and psychological symptoms. The study population included all students in grades 5, 7, and 9 (mean ages: 11.6, 13.6, and 15.6 years, respectively) in a random sample of schools in Denmark (participation rate: 88.5%; N = 5205). The students reported health problems, medicine use, bullying, and a range of psychosocial conditions in an anonymous standardized questionnaire. The outcome measure was self-reported medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness. The determinant was frequency of exposure to bullying, measured with 1 item. In multivariate models adjusted for age and social class, we found that adolescent victims of bullying used medicine for pains and psychological problems more often than did adolescents who were not bullied. The increased odds of using medicine were not explained by the higher prevalence of symptoms among the bullied children. We found victimization from bullying to be associated with medicine use, even when we controlled for the higher prevalence of symptoms among bullied victims. The medications that adolescents use can have adverse effects, in addition to the potentially health-damaging effects of bullying. Policy makers, health care professionals, and school staff should be aware that the adolescent victims of bullying are prone to excess use of medicine, and preventive actions should be taken to decrease the level of bullying as well as the use of medicine among adolescents.

Medicine Use Among 11- and 13-Year-Olds: Agreement Between Parents' Reports and Children's Self-Reports

The validity of children's self-reports on medicine use has not been reported. To determine the agreement between parents' and children's reports of medicine use for 5 common complaints and to analyze predictors for disagreement. We used the child-parent validation survey from the research project Health Behaviour in School-Aged Children. Three hundred ninety-three 11- and 13-year-old Danish children and their parents responded to identical questionnaires. The main outcome measures were self-reported medicine use during the previous month for headache, stomachache, difficulties in falling asleep, nervousness, and asthma. The percent agreement was lowest with medicine use for headache (64.6%), but was very high for the other 4 complaints (85.3-91.8%). The simple kappa coefficients were moderate to good for medicine use for headaches, stomachache, and asthma (0.31-0.58) but poor for difficulties in falling asleep and nervousness. Children who had the specific complaint during the previous month were more likely than their parents to report more frequent medicine use. We have some confidence in young adolescents' self-reports of medicine use, as the results of this study are in keeping with other studies on the validity of children's reports of health-related behaviors. Furthermore, the findings suggest that such data can be used in epidemiologic studies that aim to categorize children into groups with and without medicine use.

Is Medicine Use in Adolescence Risk Behavior? Cross-Sectional Survey of School-Aged Children from 11 to 15

Purpose To examine the association between smoking, drunkenness, and medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness in a representative sample of 11- to 15-year-old school-aged children. Methods Design: Cross-sectional school-based survey. Setting: A random sample of schools in Denmark in 2002. Participants: All students in the fifth, seventh and ninth grades in these schools, n = 4824. Measurements: Self-reported medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness within the last month; self-reported experience of drunkenness; self-reported smoking. Results There was a strong and graded association between drunkenness and medicine use, even in models adjusted for the symptom for which the medicine was taken. There was a similar association between medicine use and smoking. Conclusions The findings suggest that medicine use can be regarded as part of a cluster of risk behaviors among young people.

Self-reported medicine use among adolescents from ethnic minority groups

The migration of new population groups into Europe is an important feature of modern societies. Medicines are used in all societies to a varying degree to deal with health problems, but the use of medicine among ethnic minority groups is a neglected research issue. This paper examines self-reported medicine use for four common symptoms among ethnic minority groups in a random sample of 11-, 13and 15-year-olds in Denmark. In the year 2000, approximately 94% of the Danish population were ethnic Danes. In this study, we defined an ethnic group by the language spoken at home because mastering the national language is one of the most effective gateways to cultural integration.

Patterns of medicine use in a general population (0-80 years). The Influence of age, gender, diseases and place of residence on drug use in Norway.

Data from the Norwegian Health Survey, a national cross-sectional study, were collected through interviews with a randomly drawn sample of members of private households, including 5454 women and 5122 men (0-80+ years) in 1985. The response rate was 78.7%. They were interviewed at home and asked questions regarding health conditions and drug use in the preceding 14 days due to diseases, illnesses or injuries. Drug use decreased with age in childhood, but the overall age trend showed an increase with age. The gender differences were observed through the childbearing years (15-49 years) and above 70 years of age. Higher medicine use in women compared with men was due to a higher frequency of diagnoses of diseases/illnesses/injuries and a higher medicine use among those women with a diagnosis. Higher medicine use among women due to women's reproductory role can only be a part of the explanation. The gender difference in medicine use was also distinct after the menopause. Use of both prescribed and non-prescribed medicines was sporadic, and self-medication decreased in both sexes when obtaining medicines from the doctor. The regional variations in self-reported medicine use were mainly due to variation in the frequency of self-reported diseases/illnesses/injuries.

Validation of two methods of data collection of self-reported medicine use among the elderly.

Validation of two methods of data collection of self-reported medicine use among the elderly.